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HMAP 5300 MIDTERM EXAM 2025 ACTUAL EXAM WITH COMPLETE QUESTIONS AND CORRECT ANSWERS GRADED A+
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HMAP 5300 MIDTERM EXAM 2025 ACTUAL EXAM WITH COMPLETE QUESTIONS AND CORRECT ANSWERS GRADED A+
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HMAP 5300 MIDTERM EXAM 2025 ACTUALEXAM WITH COMPLETE QUESTIONS AND
CORRECT ANSWERS GRADED A+
Define "access." Correct Answer The ability for an individual to
obtain health care services when needed (not the same as
insurance).
What is a "global budget" as it relates to a developed nation with
a national health care program? Correct Answer It's what health
care systems in other nations use to determine total health
expenditures on a national scale and allocate resources within
their budgetary limits. Availability of services and payments to
providers subject to budgetary constraints. Costly medical
technology and specialized services may be restricted as a result.
What allows Americans access to health care services? Correct
Answer (1) Insurance through employers, (2) covered by the
government, (3) can afford insurance themselves, (4) can pay for
services privately, (5) or can obtain charity or subsidized care.
Federally-supported health centers are only located in certain
geographic regions and provide limited specialized support.
Why is the health care delivery system not governed by the free
market? Correct Answer Patients are not the ones that drive
demand or able to choose from any provider. Most people enroll
in a plan that acts as intermediaries on their behalf, so it's the
administrators of these plans that work with providers. Prices are
therefore are determined by the payers, and there is no free
competition because integrated delivery systems or other types of
partnerships or alliances created monopolies in which financial
benefit to these organizations and its administrators, who are
,driven and incentivized by their ability to be profitable--often at the
expense of the individual patients.
What are other individual affordances in a free market that is not
true in the U.S.? Correct Answer A free market also requires that
patients are informed when selecting services. Because of how
complex everything has gotten, they don't have the time,
knowledge, or resources to be well-informed. They also should
have information on the price and quality, but it's hard to figure
that out because they're nickel-and-dimed separately by a variety
of ancillary "phantom providers."
What does it disadvantage consumers when insurers act as
intermediaries between the financing and delivery functions of
health care? Correct Answer Because they have no incentive to
be a patient's advocate on price or quality. While individuals can
complain to their employers and employers can theoretically
choose a different plan, they're incentivized to lower costs to the
business and potentially contract with plans that don't provide
great benefits.
Define "need" Correct Answer The amount of medical care that
experts believe a person should have to remain or become
healthy.
How does the delivery of health care create its own demand?
Correct Answer Greater utilization due to self-assessed need and
moral hazard. Practitioners may also have a financial interest in
additional treatments that are unnecessary. All of this create
unnecessary demand.
The charge for services that are hidden from patients from
providers is referred to as billing from who? Correct Answer
Phantom providers, who bill for their services separately. It may
,be overcome by package pricing (sort of like out the door cost),
but this hasn't happened.
In terms of competing interests, describe the motivation of the
following group: PHYSICIANS Correct Answer Maintain incomes,
minimize disruption to practice
In terms of competing interests, describe the motivation of the
following group: INSTITUTIONAL ADMINISTRATORS Correct
Answer Maximize reimbursement from private and public
insurers
In terms of competing interests, describe the motivation of the
following group: INSURANCE COMPANIES/MCOs Correct
Answer Maintaining their share of the health insurance market
In terms of competing interests, describe the motivation of the
following group: EMPLOYERS Correct Answer Contain the costs
they incur for providing health insurance to their employees
In terms of competing interests, describe the motivation of the
following group: GOVERNMENT Correct Answer Maintain or
enhance existing benefits in public programs while containing the
cost of providing these benefits
Define the follow therapeutic intervention: PRIMARY
INTERVENTION Correct Answer Activities undertaken to reduce
future possibility of disease, like smoking cessation programs
Define the follow therapeutic intervention: SECONDARY
INTERVENTION Correct Answer Early detection and treatment
of disease, like health screenings
, Define the follow therapeutic intervention: TERTIARY
INTERVENTION Correct Answer Interventions that prevent
complications from chronic disease, like bed turning
What do people who apply Moral Hazard believe? Correct Answer
People can be better consumers of healthcare.
Do current trends in U.S. healthcare include increasing the use of
mid-level providers? Correct Answer Yes.
What is defensive medicine? Correct Answer When providers
deliver unnecessary services with the objective of protecting
themselves against lawsuits.
What are the primary objectives of a healthcare system? Correct
Answer An acceptable healthcare delivery system should have
two primary objectives: (1) Enable all citizens to obtain needed
healthcare services, and (2) Ensure that services are cost-
effective and meet certain established standards of quality.
Where is acute care delivered? Correct Answer Hospitals
What does the continuum of health care services refer to? Correct
Answer A range of health care services that go beyond what
hospitals and physicians provide.
What is the largest type of healthcare expenditure in the United
States? Correct Answer Hospital care at 33% (Source: The
Hamilton Project). Professional services (physician and
nonphysician outside hospital) at 26%.
In the U.S., state and local governments spend approximately
what percentage of their total expenditures on public health?
Correct Answer 3%
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