(Capella) BHA4009 Health Care Reimbursement Systems - Midterm Readiness Exam Guide(Capella) BHA4009 Health Care Reimbursement Systems - Midterm Readiness Exam Guide(Capella) BHA4009 Health Care Reimbursement Systems - Midterm Readiness Exam Guide
,1. Which of the following models focuses on the payment
structure that incentivizes health care providers for quality
of care rather than quantity?
- A) Fee-for-Service
- B) Value-Based Care
- C) Capitation
- D) Pay-for-Performance
- Correct Answer: B) Value-Based Care
Rationale: Value-Based Care emphasizes outcomes
and quality, rewarding providers for delivering high-quality
services.
2. In which reimbursement model do providers receive a
set amount per enrolled patient, regardless of the number of
services provided?
- A) Fee-for-Service
- B) Capitation
- C) Global Budget
- D) Cost-Plus
- Correct Answer: B) Capitation
Rationale: Capitation is a payment arrangement where
providers are paid per patient, regardless of how many
services they provide.
, health care providers
Rationale: RVUs help determine reimbursement rates
based on resource costs, time, and complexity involved in
providing a service.
4. Which of the following is a risk-sharing mechanism
commonly used in Accountable Care Organizations
(ACOs)?
- A) Bundled Payments
- B) Fee-for-Service
- C) Capitation
- D) Shared Savings
- Correct Answer: D) Shared Savings
Rationale: Shared Savings programs in ACOs allow
providers to share in cost savings achieved through
improved efficiency and quality.
5. Which federal program provides health coverage for
individuals with low income, primarily focusing on families
and children?
- A) Medicare
- B) Medicaid
- C) TRICARE
- D) CHIP
- Correct Answer: B) Medicaid
Rationale: Medicaid is designed to provide health care
coverage for low-income individuals and families.
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