mid term exam Flashcards
which of the following best describes the method of funding for health care in the united states?
- CHIP and TRICARE
- fee for service
- blue cross and medicare
- private payers and public programs
private payers and public programs
what was the traditional method of reimbursement for health services before passage of the Affordable Care Act (ACA)?
- fee for service
- payer
- medicare
- private insurance
fee for service
which of the following groups of people is eligible for medicare?
- any adult with cancer
- age 60 or older
- any adult with end-stage renal disease
- age 55 or older
any adult with end-stage renal disease
which group developed the first private hospital insurance plan in 1929?
- teachers
- nurses
- coal miners
- doctors
teachers
in 2019, medicaid provided coverage to how many Americans, which makes it the nation’s largest public health insurance program?
- 2 in 10
- 1 in 10
- 2 in 5
- 1 in 5
1 in 5
the most significant change in government healthcare financing was when Congress approved which of these health insurance programs with the passage of Title XVIII and Title XIX, respectively, of the Social Security Act of 1965?
- medicaid
- CHIPS
- ACA
- CDC
medicaid
which of the following statements best describes the “fee-for-service” model of payment?
- services are paid for on a sliding scale considering severity
- services are paid for depending on the person’s ability to pay
- all services are prepaid at a set fee for each
- the payee is financially rewarded for volume of services rather than for quality of service or cost control
the payee is financially rewarded for volume of services rather than for quality of service or cost control
t/f
managed care organizations is a healthcare delivery system designed to manage cost, utilization, and quality.
true
t/f
in 1983, congress passed a prospective payment bill, under which hospitals are paid a set amount for each patient according to the length of time they stayed in the hospital.
false
t/f
in 2019, total healthcare spending was $3.8 trillion, representing 27.7% of the gross domestic product (GDP) in the united states.
false
the aging of our population has important implications on which of the following? (select ALL correct answers)
- caregiving
- social services
- health care
- higher education
- caregiving
- social services
- health care
which of the following statements about medicaid is true? (select ALL correct answers)
- covers the same services as medicare covers
- it covers prescription drugs
- it is the primary payer for and the only safety-net program for long-term services and supports for many low and middle-income families
- it serves as a supplemental insurance for disabled people
it pays medicare premiums
- it covers prescription drugs
- it is the primary payer for and the only safety-net program for long-term services and supports for many low and middle-income families
- it serves as a supplemental insurance for disabled people
it pays medicare premiums
privately funded long-term care providers that are regulated by federal and/or state governments include which of the following? (select ALL correct answers)
- adult day care
- hospice
- residential care communities
- specialty acute care hospitals
- home health agencies
- adult day care
- hospice
- residential care communities
- home health agencies
which of the following will be the most important disability associated with our aging population?
- contagious diseases
- acute diseases
- chronic diseases
- orthopedic injuries
chronic diseases
medicare health insurance is divided into four parts. which part covers prescription medications?
- medicare A
- medicare D
- medicare B
- medicare C
medicare D
which of the following is the federal requirement that is designed to ensure that individuals are not inappropriately placed in nursing homes for long-term care?
- the preadmission exam for needs and distribution (PEND)
- the preadmission screening and resident review (PASRR)
- the federal long term care screening test (FLTCST)
- the resident ability screening test (RAST)
the preadmission screening and resident review (PASRR)
what is the name of the program supported by the CMS that provides comprehensive preventive, primary, acute, and long-term care services so that older individuals with chronic care needs can continue living in the community?
- pacer
- medicaid
- medicare
- PACE
PACE
t/f
changes in the racial and ethnic composition of the U.S. population should have no significant consequences for the nation’s health.
false
t/f
the majority of americans report that they have a reasonably easy time understanding and using health information needed for them to make appropriate health decisions.
false
t/f
requirements for personnel specifically prepared to serve older people will greatly exceed the current supply.
true
which of the following is an essential health benefit required by all qualified health plans? (select ALL correct answers)
- laboratory services
- maternity and newborn care
- emergency services
- prescription drugs
- behavioral health treatment
- laboratory services
- maternity and newborn care
- emergency services
- prescription drugs
- behavioral health treatment
which of the following are the goals of the affordable care act (ACA) of 2010? (select ALL correct answers)
- decrease use of preventative health services
- increase the need for prescription drug use
- slow the rising costs of health care
- decrease the number of uninsured
- increase the quality and efficiency of health care
- decrease the need for medical testing and equipment
- slow the rising costs of health care
- decrease the number of uninsured
- increase the quality and efficiency of health care
which of the following readmission diagnoses were monitored in 2012 for failure to meet standards, causing lower medicare payments to hospitals? (select ALL correct answers)
- diabetes
- pneumonia
- urinary tract infection
- heart attack
- high blood pressure
- stroke
- pneumonia
- heart attack
- stroke
t/f
ACOs that failed to meet the standard for quality and cost savings were financially responsible for the healthcare costs of patients instead of medicare.
true