ch 3

Question 1

-What are examples of a government-funded health insurance programs?

Answer 1

Medicare, Medicaid, and CHIP

Question 2

-In 2019, which programs comprised a total of 25% of the federal budget?

Answer 2

Medicare, medicaid, CHIP, Market place subsidies

Question 3

what is “fee for service”

Answer 3

volume of service paid to provider

Question 4

• What were the top two Medicare benefit payments in 2014

Answer 4

Hospital inpatient services and private insurance

Question 5

• What were the highest and the lowest Medicare expenditures in 2013

Answer 5

Acute care and mental health

Question 6

• In 2019 Medicaid provided coverage to 1 in 5 Americans, which makes it the nation’s largest public health insurance program. T/F

Answer 6

true

Question 7

• True or False? The first pre-payment plan to cover physician services was Medicare.

Answer 7

false

Question 8

• True or False? In 1983, Congress passed a prospective payment bill under which hospitals are paid a set amount for each patient in any of the established disease categories and Diagnosis-Related Groupe (DRGS).

Answer 8

true

Question 9

• True or False? The first managed care insurance programs were started with PPOs: Kaiser Permanen in Califomia and Group Health Cooperative in Washington State.

Answer 9

false

Question 10

• True or False? About 85% of those offered health insurance through their employer actually enroll.

Answer 10

false

Question 11

• In an effort to control rising healthcare costs, both public and private health insurance programs have moved to _____

Answer 11

capitation

Question 12

• The
  ______
  program is a federal health program for people aged 65 years and
  older, certain disabled people younger than 65, and any adult with permanent kidney failure (end-stage renal disease) or amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease).

Answer 12

Medicare

Question 13

____ is the federal-state cooperative health insurance plan for people who are
not eligible for health insurance through an employer and who cannot afford to buy health insurance through the Marketplace.

Answer 13

Medicaid

Question 14

• Private funding is primarily through private health insurance, with what percentage of Americans having employer-sponsored health insurance in 2015?

Answer 14

57%

Question 15

• Health care in the United States is funded through a variety of private payers, as there are no public programs available in this country. T/F

Answer 15

false

Question 16

• Capitation as a method of reimbursement is best described as

Answer 16

amount paid to the provider for medical
service

Question 17

• The traditional method of reimbursement for health services before the passage of the Affordable Care Act was fee-for-service. T/F

Answer 17

true

Question 18

• Examples of government or public health insurance programs include

Answer 18

Medicare, Medicaid, and
TRICARE

Question 19

Medicaid is the federal-state cooperative health insurance plan for which group of people?

Answer 19

Individuals with low income

Question 20

• Medicare and Medicaid are government or public health insurance programs that benefit 1 in 10
  Americans. T/F

Answer 20

false

Question 21

• What best describes a Health Maintenance Organization (HMO)?

Answer 21

HMO does not cover out-of-network care except an emergency

Question 22

• The first managed care insurance programs were started with HMOs. T/F

Answer 22

true

Question 23

• Managed Care Organizations are divided primarily into HMOs, PPOs, and Exclusive Provider Organizations. T/F

Answer 23

true

Question 24

• In what year was Medicare expanded to include those with certain disabilities, chronic kidney disease, and ALS?

Answer 24

1972

Question 25

• Government-sponsored healthcare efforts were initiated at the state and federal level at the same time.

Answer 25

at different times

Question 26

-The availability of employer-sponsored coverage has been increasing, with an increase from 50% to 67% between 2000 and 2015. T/F

Answer 26

true

Question 27

-Nearly two-thirds of total Medicaid expenditures cover either the elderly or persons with disabilities. T/F

Answer 27

false

Question 28

• In 2019, what was the total amount of the annual premium for employer-based health insurance for family coverage?

Answer 28

$20,576

Question 29

• In 2019, total Medicaid expenditures were nearly $613 billion, with one-third of expenditures spent on long-term services and supports in 2018. T/F

Answer 29

true

Question 30

-Nearly two-thirds of total Medicaid expenditures cover either the elderly or persons with disabilities. T/F

Answer 30

false

Question 31

-Changes in the way health care is being paid for in both the public and private sectors will impact healthcare personnel and career opportunities. How would you describe the way in which career opportunities will be impacted?

Answer 31

more job opportunities.