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Health 3050 Final ECU IRONS Exam Questions and Answers $12.49   Add to cart

Exam (elaborations)

Health 3050 Final ECU IRONS Exam Questions and Answers

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  • Course
  • NUR 3050
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  • NUR 3050

Health 3050 Final ECU IRONS Exam Questions and Answers

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  • November 1, 2024
  • 9
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • NUR 3050
  • NUR 3050
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lectknancy
Health 3050 Final ECU IRONS Exam
Questions and Answers
Determinants of Health - Answer-Factors that contribute to a person's current state of
health.

Effects of Social Determinants - Answer-Example: Low socioeconomic status when
growing up can lead to poor education which leads to low paying jobs and little to no
health care for that person's future

Research shows that health-related behaviors are linked to 3 things; income, education
level and employment

Role that policy and law play on Social Determinants - Answer-The law can be used to
design and perpetuate social conditions that can have terrible physical, mental, and
emotional effects on individuals and populations-- Jim Crow Laws

The law can be utilized as a mechanism through which behaviors and prejudices are
transformed into distributions of well-being among populations.

Laws can be determinative of health through their under-enforcement

Law can be used to structure direct responses to health-harming social needs that
result from things like impoverish, illness, market failure, and individual behavior that
harms others

Benefits - Answer-The list of services covered by the health insurance plan

Examples: blood work, MRI, X-Rays

Beneficiaries - Answer-Individual who buys health insurance

Fee for Service - Answer-Where providers charge a fee for every service they render

Premium - Answer-Annual fee paid by the beneficiary to the health plan

How Premiums are paid - Answer-Paid in monthly installments in 1 of 3 ways:
1. Completely by the individual
2. Completely by the employer
3. Shared between the individual and employer

Your premium means the insurance company will pay for healthcare costs, as long as
the costs are covered with the benefits outlined in your plan

, Setting Premiums - Answer-Insurance companies set premiums to cover most of their
expenses

Experience Premium Rates - Answer-Based on health status and claims in prior year(s)

Community Premium Rates - Answer-Use only geography and family composition to set
rates

Deductible - Answer-The amount of money you pay first, before your health insurance
starts to pay

Cost Sharing - Answer-Costs shared between the insurance company and the individual
seeking health care

2 ways: Co-insurance or Co-payments

Co-Payments - Answer-A set dollar amount the beneficiary must pay at time services
are rendered

Co-insurance - Answer-The amount of the bill that the individual must pay AFTER the
deductible is met.

Out of pocket maximum - Answer-The most money you have to pay out of pocket per
year

Risk and Uncertainty - Answer-Individual: People choose to be insured because of
uncertainty and risk

Insurance Companies:
-they are businesses that need to cover the cost of their expenditures
-uncertainty and risk of customers can lead to adverse selections
-make more money when healthy people buy insurance

Managed Care - Answer-Managed care integrates the provision and payment of health
care services

Ideally, managed care contains costs while providing necessary and high quality health
care services

Why were Managed Care established? - Answer--Rising healthcare costs
-No mechanisms for cost containment under fee for service (FFS)
-FFS does not create incentives to use lowest-cost quality care available
-Insurance companies can't control access and costs in the FFS

Benefits of Managed Care - Answer--Defined package of benefits (premiums and cost
sharing) for a pre-set fee

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