HMGT Test 1, Questions and answers, 100% Accurate, rated A+
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Course
HMGT
Institution
HMGT
HMGT Test 1, Questions and answers, 100% Accurate, rated A+
?!?!?!?!?!?!? HOW TO READ THE CARDS ?!?!?!?!?!?!? - -1.) CHAPTER 1
2.) CHAPTER 2
3.) CHAPTER 3
5.) CHAPTER 5
D.) DEFINITION
(Everything was taken directly from slides and definitions are based on what Dr. Jim emphasized on in ...
1.) What are the two main theoretical objectives of a health care delivery system? - ✔✔--All Citizens
obtain Health Care Services when needed
-Health Care Services should be cost effective & high quality
1.) What are the four basic theoretical functional components of the US health care delivery system?
How do they interact with one another? - ✔✔-better image page 6 in textbook
1.) What are the primary reasons employers provide health insurance for their employees? - ✔✔--
Employment Benefit in-lieu of salary - tax avoidance
-Help maintain healthy work-force - i.e. Productivity/presenteeism
-Reduce Turnover rate - Attraction/Retention of Talent
,1.) Why do some US residents/citizens live without health insurance? - ✔✔--Individual autonomy -
choices of income allocation
-Poverty & Low Healthcare Literacy
-Not offered by Employer or High % Premium sharing
1.) How does the Affordable Care Act (ACA) impact US residents/citizens live without health insurance? -
✔✔--Requires all Americans to have health insurance
-Expansion of Medicaid Eligibility for coverage
-Development of Subsidized Health Insurance Marketplace
-Requirements for Health Insurers (lifetime limits, age limits)
1.) What is managed health care? What is a managed care organization (MCO)? - ✔✔--Supporting
Employer-sponsored Health Insurance to control utilization by employees
-Employee/Enrollee Member Benefit Plan Design - includes Deductibles, Co-Pays, Benefits & Provider
Network Limits
-Negotiated Payments (Fee Structures) for Providers
1.) Why is the US heal1th care market called an "imperfect market"? - ✔✔-In a Free (Perfect) Market:
-Consumer Demand - sensitive to Price
-Supply Levels - sensitive to Demand
-Information & Transparency is Required
1.) What is the intermediary role of health insurance in the delivery of health care in the US? - ✔✔--
Negotiates the Rate of Fees (i.e. Provider Fee Schedule) that Employers will pay providers
-No incentive to control costs or quality
-Introduces the "Moral Hazard"
-Delivery of health services can result in demand creation (self-assessed need)
1.) Name the major players in the US health care delivery system? - ✔✔--Physicians & Hospitals
-Business
, -Government
-Labor
-Consumers
-Payers/Insurers
-Pharma
1.) What are the key roles for government in the US health care delivery system? - ✔✔--Purchase Health
care services for elderly & poor
-Public Health - domestic threats (i.e. Zika, Ebolz, W. Nile, TB, Syphilis, STDs, Measles, Mumps, Influenza,
etc.)
-Public Policy - Expansion of Coverage, Research, etc.
-Regulation of Fee Market - Consumer Protection
1.) Why is it important for health care managers and policy makers to understand the intricacies of the
US health care delivery system? - ✔✔--Changes in one area inevitably impacts other areas - unintended
consequences
-Opportunities for synergies
-The power of innovation, technology and research to structurally change the system
1.) Explain the difference between National Health Insurance and National Health System? - ✔✔--
National Health Insurance
-National Health System
D.) National Health System - ✔✔-Government-controlled and managed health care delivery and
payment
D.) National Health Insurance - ✔✔-Government-sponsored health insurance, but the delivery system is
private
1.) Explain the definition of Socialized Health Insurance (SHI)? - ✔✔-Government-mandated
contributions by employers and employees, integrated by government mandates and regulations
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