Health Systems Midterm

Which of the following is not an example of a behavior associated with disease prevention?

d. er visit for a broken leg

What is the most accurate definition of morbidity ?

c. condition of suffering from a disease or medical condition

Under which payment strategy are physicians paid a fixed amount regardless of the number of patients they serve?

d. salaried providers

What is one factor that has limited the ability of managed care organizations (MCOs) to continue to reduce costs?

d. In response to the development of MCOs, health care providers have consolidated to improve their bargaining power when negotiating with MCOs.

Which payment strategy is used to allow managed care organizations to pay less for the same service as other insurers?

d. negotiated fee discounts

What is not true about accountable care organizations in health care?

d. they do not accept medicaid patients

Health care should be provided at the _____ and ______

b. highest quality and lowest cost

Compared to other economically advanced countries, the US has fewer

a. Primary care physicians

Allied health professionals

a. Preform skilled procedures often in a hospital or clinic setting.

What are key challenges for value-based pay programs?

b. Monitoring physician performance and incentivizing providers to focus on populations that are more difficult to serve.

Health service administrators

c. Are principally responsible for planning and coordination of health care delivery. 

Which type of care is the first level of contact between the health system and individuals?

a. Primary care

Which of the following is not an example of a modifiable health risk?

d. Genetic predisposition to disease 

Which term best describes a fixed fee that patients pay for a physician visit?

c. copayment

When did penicillin use become widespread?

1. 1940s 

Which type of insurance plan serves primarily low-income populations

d. Medicaid 

What is the main source of information asymmetry that creates challenges for efficient provision of health insurance?

d. Patients know their personal health risks and behaviors better than insurance providers. 

Which type of federal policy provides incentives for firms to conduct research to develop new medical technology?

c. Patent laws

The field of health informatics…

c. Uses electronic health records to improve clinical efficiency. 

Which determinant of health is least likely to be influenced by discrimination

d. Heredity  

What is the best definition of market justice ?

c. The use of markets to allocate scarce health care resources to those who participate in the market.

During what period of time did US hospitals begin to develop as key health care institutions for wealthy individuals?

b. Late 1800s

What is the best definition for patient days ?

b. Number of night that a patient spends in the hospital.

Which type of utilization review is used to control the use of specialized health care services?

d. Prospective review

How did European hospitals compare to US hospitals in the 1700 and 1800s?

d. European hospitals were often superior to US hospitals. 

In what way is gatekeeping used by MCOs?

b. Primary care physicians coordinate all specialist care by making referrals.

The growing prevalence of ______ disease has shifted the focus of health care towards prevention.

d. Chronic 

Which type of care is highly specialized and usually occurs in large hospitals

c. Tertiary care

_____ has intensified the need to focus on preventive health.

d. High health care costs 

Community health workers

a. Connect health care services to communities.

Which type of care is involved with trauma care, burn treatment, and tissue transplant

c. Tertiary care

When systems are aligned, the boundaries between different sub-systems…

c. Become well establish with identified windows and doors.

The first hospital sponsored insurance plan was marketed primarily to…

b. School teachers

Which type of insurance plan serves primarily people over the age of 65?

b. Medicare

Reimbursement method in which poor performing hospitals are penalized, and high performing hospitals are rewarded.

c. Value based payment

Reimbursement method is most likely to produce cost escalation.

c. Fee for service

Employer provided health insurance plans do NOT include.

d. Medicare part D options 

There are 3 primary categories through which medical technology is regulated. These include all of the below EXCEPT

b. Genomics 

Medical technology…

a. Has increased life expectancy and health care costs.

Which of the following is an example of an acute condition?

b. Influenza

What is the best definition of acute condition ?

b. health condition that develops rapidly and usually has limited duration

Under which payment strategy is a provider paid a fixed monthly amount per patient?

c. Capitation

By what year did managed care plans become the dominant form of health insurance in the United States?

d. 1990 

Which type of care is usually relied upon for disease prevention?

a. Primary care

Which determinant of health is most strongly impacted by the formal healthcare system?

a. Medical care

Which of the following is not a payment strategy used by managed care organization to reduce costs?

c. Fee for service

Which nursing certification requires advanced training beyond a bachelors degree?

d. Nurse Practitioner

Which type of insurance plan is likely to be the most effective at minimizing moral hazard?

a. High deductible plan

HMO and PPO are two examples of…

a. Managed care organizations

Which type of insurance plan serves primarily veterans

a. CMAPVA and TRICARE

Utilization of medical technology…

Is very high in the US compared to other developed countries 

Any medical technology that is derived from living organisms is regulated under the category of…

Biologics 

Which of the following is an example of a chronic condition?

b. Diabetes

Under which payment strategy is a provider paid a fixed monthly amount per patient?

a. Capitation

What is not a strategy used to help control health care costs in the US?

c. Systematically withholding costly technological advances until they can be made affordable

By what year did managed care plans become the dominant form of health insurance in the United States?

d. 1990 

What nursing certificate does not require a college degree?

c. Licensed vocational nurse

Population health is primarily concerned with…

b. Health outcomes of a group of individuals

When did Medicare and Medicaid begin?

1960’s 

Reimbursement method in which hospital care is paid for as a per-determined bundled price based on the patient's diagnosis

d. Diagnosis-Related Group payment 

Which type of insurance plan began to dominate the market in the 1990's

b. Managed Care Organization

Reimbursement method in which hospitals can be penalized for high re-admissions and preventable hospital-acquired conditions

Value-based payment 

Precision medicine…

c. allows clinical recommendations to be based on patients' individual characteristics instead of average outcomes 

What are the three pillars of medical education?

a. clinical, basic, and health system sciences

What is the best definition for hospital occupancy rate?

c. percentage of the hospital capacity used during a given period of time

Which health insurance model prioritizes wide accessibility over individual choice?

1. b. Universal public insurance 

Which health care rationing strategy systematically constrains patients health care choices?

b. Gatekeeping and queuing 

Cross-sector collaboration is enhanced by…

c. shared vision and goals 

Which cause of health disparities includes housing discrimination?

b. Social & Systemic

The Administration for Native Americans reports to the Secretary of Health through the…

c. office of health development services

What is a disadvantage of providing free health care paid for by the government?

d.   Patients have no incentive to weight the financial costs of care against the likely benefits 

Managed care organizations are incentivized to find ways to lower health care costs because…

They assume the cost of health care for their insured patients and also have to keep insurance premiums low to continue to attract patients 

Which type of utilization review is used to detect patterns of health care over- or under-utilization?

b. retrospective review

Patient-centered care….

d. is a principal of care in which patients' values guide all clinical decisions

A physician who manages patient cases within a hospital is an example of

c. hospitalist

The earliest forms of health insurance in the labor sector took the form of…

b. worker compensation

Which type of insurance plan was made available to a larger population through the Affordable Care Act?

d. Medicaid

Medical technology….

d. has increased life expectancy and health care costs 

There are 3 primary categories through which medical technology is regulated. These include all of the below EXCEPT

a. genomics

Choose the domain of health system effectiveness most closely related to the scenario described. Dr. Varna asks patients if they would like to include their caregivers in health discussions and rearranges his hospital rounds to accommodate this communication.

e. Patient-centered  

Choose the domain of health system effectiveness most closely related to the scenario described. Francis health system closed their Fredrick hospital because the number of patients in the community seeking care was dwindling as the neighborhoods surrounding the hospital became home to more lower-income families.

f. effective

Which payment strategy prevents physicians from earning more money by recommending more treatments?

c. Salaried physicians 

Which health insurance model provides insurance to select populations that have trouble finding insurance in the private market?

a. Means-tested insurance 

Choose the domain of health system effectiveness most closely related to the scenario described. New immunotherapy drugs are extending the life of cancer patients.

f. Efficient 

Choose the domain of health system effectiveness most closely related to the scenario described. Electronic health records allow for improved sharing of patient information between members of the treatment team; this improves effectiveness of care and makes care giving more ______.

c. Efficient 

Which of the following is not a strategy through which managed care organizations encourage integration of health care services to improve quality?

c. disincentivizing the use of neighborhood health clinics 

What is a prospective payment system?

c. health care costs are paid for based on a predetermined amount associated with the patient's condition 

What is a reason why a fully individualized approach to health care is difficult?

d. one individual's health impacts the health risks of others through disease transmission and/or the allocation of scarce resources 

Which payment system below does not concern itself with connecting provider payments to the quality of care provided?

c. Fee-for-service

Health disparities are…

b. differences in health that are avoidable and unjust 

Which type of insurance plan had the largest market share in the 1970's, but is used infrequently today?

d. group insurance

Which cause of health disparities includes income inequality?

b. Economics 

Which type of insurance plan serves primarily children?

1. CHIP  

In what way is gatekeeping used by managed care organizations?

1. primary care physicians coordinate all specialist care by making referrals 

Which type of care includes routine surgery and specialty consultations?

1. Secondary care 

What is one of the biggest factors that makes disease prevention challenging?

1. Health care costs for treatment continue to rise 

When was CHIP established?

1. 1990's 

Generally, who is most willing to pay the most for health insurance?

1. People most at risk of poor health 

When was the Affordable Care Act first implemented? 1940's 1950's 1960's 1970's 1980's 1990's 2000's 2010's 2020's

1. 2010's 

Reimbursement method in which each health service is billed separately.

1. Fee for service