Quiz Flashcards
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?
Market Differentiation
Analyzing challenges or barriers to starting a new cardiac rehab program would be an example of what part of a SWAT analysis
Threats
Applying for and obtaining a no-strings attached grant for a community based program is an example of equity or debt financing
neither
a _____ is a detailed analysis that can help to determine the likelihood of success of a business venture
feasibility study
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
false
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 ___________________.
opportunity cost
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 __________________.
cost plus pricing
what is an effective method for monitoring expenses and projecting revenues
constructing an annual budget
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.
false
Are premiums for PPOs higher than premiums for HMOs
true
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:
fee for service
is setting up a clear, consistent discount based on ability to pay allowed in a clinic that accepts gov payers
yes
Do HMOs have lower out of pocket costs at time of service compared to PPO
yes
As cost of an insurance policy increases, the comprehensiveness of services typically:
goes up
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:
payment per episode
A beneficiary’s insurance policy is 80/20 based on provider charges. What does the 80 represent?
percentage the insurer is responsible for paying
Individuals with traditional Medicare, seen by a physical therapist while under Observation Status in a hospital, use Part B Medicare benefits.
true
All states expanded Medicaid under Healthcare Reform.
false
Federal law requires that cost sharing for individuals on Medicaid is identical, regardless of income.
false
If states adopt a work requirement under Medicaid, all individuals will be required to work.
true
medical insurance, including outpatient
part b
hospital insurance including inpatient
part A
medicare drug
part d
medicare advantage
part c
which is not covered by medicare: SNF, custodial care, home health, inpatient rehab
custodial care
Mike Julian is a Medicare beneficiary. In order to qualify to receive services in a Skilled Nursing Facility, which of the following must apply?
he must have been hospitalized in the past 30 days
Which of the following are TRUE about the Medicare Therapy Cap?
applies to all outpatient physical therapy settigns
What is the triple aim
improved health
cost containment
improved health care
CMMI was given wide authority to
lower spending without reducing the quality of care
improve the quality of care without increasing spending
a group of providers agree to collaborate on both cost and quality in exchanged for shared incentives
ACO
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?
bundled payment
In Bundled Payment models, which of the following are methods insurers use to offset the risk of over or under treatment by providers
non financial incentives
mandates
financial incentives
in value based care what is the definition of value
health outcomes achieved per dollar spent
what is the goal of value achieved in health care
high patient outcomes and satisfaction
which of the following fits best for a medical home payment reform model
chronic disease management
what was rising before aca
deductables
premiums
cost sharing
underinsured pop
uninsured pop
which of the following was not addressed by ACA
underinsured
which of the following is true about medicaid after ACA
provider access can be challenging
more adults qualified for medicaid under ACA than before ACA
subsidies are available to many americans who buy health insurance through the exhange under ACA
true
Plans on the Exchange are required under ACA to provide rehabilitation/habilitation services as a benefit.
true
Multiple Choice: Which of the following was LEAST addressed under ACA?
cost
Which of the following were alternatives for states in developing the health insurance marketplace/exchange under ACA?
develop and open their own exchange
develop and open exhange together with gov
allow fed gov to open exchange on their behaf
What was the most substantial reason for the decrease in uninsurance rate under ACA?
medicaid enrollement
which of the following is true about bidencare
would provide more competition in the insurance marketplace
a major healthcare overhall is expected during biden administration
false
One impact of the pandemic was an increase in state expenditures on Medicaid.
true
do premiums and cost sharing exist in medicare for all
no
Sales taxes, car registration and tobacco taxes are examples of a:
regressive
In the United States, multiple loopholes have led to reduction in the amount the wealthy pay in what type of tax structure?
progressive tax
the colorado option is similar to waht
medicare part c
The graph comparing US Healthcare Expenditures to comparable countries found that the US pays more in which of the following categories?
inpatient
admin
prescription drugs
preventative care
The 2021 CMS Innovation Center Comprehensive Plan includes:
focus on health equity
The Economic Cost on the slide about the “Design Your Own Healthcare System” game is described as:
impact on the cost of healthcare
