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Health Care Delivery > Quiz > Flashcards

Quiz Flashcards

1
Q

The focus that Kaiser put on their thrive marketing campaign to link an image of wellness with their name and organization is an example of what?

A

Market Differentiation

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2
Q

Analyzing challenges or barriers to starting a new cardiac rehab program would be an example of what part of a SWAT analysis

A

Threats

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3
Q

Applying for and obtaining a no-strings attached grant for a community based program is an example of equity or debt financing

A

neither

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4
Q

a _____ is a detailed analysis that can help to determine the likelihood of success of a business venture

A

feasibility study

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5
Q

is measuring the change in the number of new patients/new evaluations per month before a marketing campaign and comparing that number to the after the campaign is run is an example of a break even analysis

A

false

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6
Q

Investing money into a marketing event when those resources could have been used to start a new clinic program is an example of a/an ___________________.

A

opportunity cost

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7
Q

Determining the price you will offer a class or service at, based on what the expense of producing it and adding in some profit, is an example of __________________.

A

cost plus pricing

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8
Q

what is an effective method for monitoring expenses and projecting revenues

A

constructing an annual budget

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9
Q

Research has shown that most patients prefer to see a different physical therapist with a new perspective on their problem for each of their PT visits.

A

false

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10
Q

Are premiums for PPOs higher than premiums for HMOs

A

true

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11
Q

When a patient is seen by the PT, the PT enters codes. Those codes are used to determine how much the clinic is reimbursed by the insurance company. This is called:

A

fee for service

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12
Q

is setting up a clear, consistent discount based on ability to pay allowed in a clinic that accepts gov payers

A

yes

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13
Q

Do HMOs have lower out of pocket costs at time of service compared to PPO

A

yes

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14
Q

As cost of an insurance policy increases, the comprehensiveness of services typically:

A

goes up

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15
Q

A hospital negotiates with an insurer based on a reduced fee schedule to provide all services for an individual after an Total Knee Replacement, including surgery, hospitalization and post-operative care. This is called:

A

payment per episode

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16
Q

A beneficiary’s insurance policy is 80/20 based on provider charges. What does the 80 represent?

A

percentage the insurer is responsible for paying

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17
Q

Individuals with traditional Medicare, seen by a physical therapist while under Observation Status in a hospital, use Part B Medicare benefits.

A

true

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18
Q

All states expanded Medicaid under Healthcare Reform.

A

false

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19
Q

Federal law requires that cost sharing for individuals on Medicaid is identical, regardless of income.

A

false

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20
Q

If states adopt a work requirement under Medicaid, all individuals will be required to work.

A

true

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21
Q

medical insurance, including outpatient

A

part b

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22
Q

hospital insurance including inpatient

A

part A

23
Q

medicare drug

A

part d

24
Q

medicare advantage

A

part c

25
Q

which is not covered by medicare: SNF, custodial care, home health, inpatient rehab

A

custodial care

26
Q

Mike Julian is a Medicare beneficiary. In order to qualify to receive services in a Skilled Nursing Facility, which of the following must apply?

A

he must have been hospitalized in the past 30 days

27
Q

Which of the following are TRUE about the Medicare Therapy Cap?

A

applies to all outpatient physical therapy settigns

28
Q

What is the triple aim

A

improved health
cost containment
improved health care

29
Q

CMMI was given wide authority to

A

lower spending without reducing the quality of care

improve the quality of care without increasing spending

30
Q

a group of providers agree to collaborate on both cost and quality in exchanged for shared incentives

A

ACO

31
Q

A set amount is paid to a hospital who coordinates all care. This amount is in exchange for cost associated with a major surgical procedure. This is an example of which of the following models?

A

bundled payment

32
Q

In Bundled Payment models, which of the following are methods insurers use to offset the risk of over or under treatment by providers

A

non financial incentives
mandates
financial incentives

33
Q

in value based care what is the definition of value

A

health outcomes achieved per dollar spent

34
Q

what is the goal of value achieved in health care

A

high patient outcomes and satisfaction

35
Q

which of the following fits best for a medical home payment reform model

A

chronic disease management

36
Q

what was rising before aca

A

deductables
premiums
cost sharing
underinsured pop
uninsured pop

37
Q

which of the following was not addressed by ACA

A

underinsured

38
Q

which of the following is true about medicaid after ACA

A

provider access can be challenging
more adults qualified for medicaid under ACA than before ACA

39
Q

subsidies are available to many americans who buy health insurance through the exhange under ACA

A

true

40
Q

Plans on the Exchange are required under ACA to provide rehabilitation/habilitation services as a benefit.

A

true

41
Q

Multiple Choice: Which of the following was LEAST addressed under ACA?

A

cost

42
Q

Which of the following were alternatives for states in developing the health insurance marketplace/exchange under ACA?

A

develop and open their own exchange
develop and open exhange together with gov
allow fed gov to open exchange on their behaf

43
Q

What was the most substantial reason for the decrease in uninsurance rate under ACA?

A

medicaid enrollement

44
Q

which of the following is true about bidencare

A

would provide more competition in the insurance marketplace

45
Q

a major healthcare overhall is expected during biden administration

A

false

46
Q

One impact of the pandemic was an increase in state expenditures on Medicaid.

A

true

47
Q

do premiums and cost sharing exist in medicare for all

A

no

48
Q

Sales taxes, car registration and tobacco taxes are examples of a:

A

regressive

49
Q

In the United States, multiple loopholes have led to reduction in the amount the wealthy pay in what type of tax structure?

A

progressive tax

50
Q

the colorado option is similar to waht

A

medicare part c

51
Q

The graph comparing US Healthcare Expenditures to comparable countries found that the US pays more in which of the following categories?

A

inpatient
admin
prescription drugs
preventative care

52
Q

The 2021 CMS Innovation Center Comprehensive Plan includes:

A

focus on health equity

53
Q

The Economic Cost on the slide about the “Design Your Own Healthcare System” game is described as:

A

impact on the cost of healthcare

Health Care Delivery (19 decks)

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