Kahoot Review Flashcards
Which of the following is not a type of cost sharing? A. Premiums B. Copayments C. Coinsurance D. Deductible
A
What type of insurance model is characterized by a contract between one payer and one physician? A. Staff Model HMO B. Group Model HMO C. Network Model HMO D. Preferred Provider Organization
B
Which health profession helps patients achieve better functional independence by working on activities of daily living? A. Speech-Language Pathologist B. Physical Therapist C. Occupational Therapist D. Medical Assistant
C
Which hospitals have provided the most consistent source of non-government funding for "charity care" A. Religious not-for-profit B. Secular not-for-profit C. For-profit D. Physician Owned
A
Which of the following is not a type of inpatient facility? A. Assisted living facility B. Inpatient rehab facility C. Long term acute care hospital D. Skilled nursing facility
A
Which group was not exempt from the ACA health insurance program? A. Undocumented immigrants B. Alaskan Natives C. Those with a religious exemption D. Those working for small employers
D
The Rand Health Insurance Experiment aligned with what major legislation?
A. Health Maintenance Organization Act
B. Medicare Prescription Drug, Improvement, and Modernization Act
C. Mental Health Parity Act
D. State Children’s Health Insurance Program
A
T/F Group/Staff HMO models gives insurers the most control over physician actions
True
Group model HMO
contract between one payer and one physician
Staff Model HMO
HMO owns health care facilities and employs physicians
Network Model HMO
HMO contracting with multiple physician groups
Independent Practice Association Model HMO
Physicians form their own organization and contracts with an HMO to provide services at a negotiated fee
Preferred Provider Organization
providers seek contracts with insurance
plans
Point of Service POS
pt required to choose a PCP within a network but can see out of network specialists
What are the three Tax-free bank accounts that can only be used for medical expenses
FSA
HSA
HRA
Define diagnostic related groups
group of ICD codes for reimbursement
T/F capitation can be defined as reimbursement per patient per month
True
Drugs given at a skilled nursing facility would be covered by? A. Part D B. Part A C. Part B D. Part C
B
What did the discontinued medigap plans cover?
part B deductible
T/F extra help (LIS) is determined by a benificiary’s income and resources
True
What is a solution to moral hazard?
cost sharing
what is a solution to adverse selection?
coverage limitations
what is a solution to incentive to create loss?
capitated payment models
what is a solution to supplier-induced demand?
prior authorizations
what is the beveridge model?
health care provided by government via taxes
what is the bismarck model?
non-profit insurance-based system financed by employers and employees
what is the national health insurance model?
government run insurance payed with taxes provided by private employers
Which countrie(s) use beveridge model?
UK
Which countrie(s) use bismarck model?
germany, switzerland
Which countrie(s) use national health insurance model
canada
what is the out of pocket model?
patients pay for medical expenses out of pocket
Which countrie(s) use out of pocket model?
china, south america
