Quiz part 1

Question 1

An insurer offering a part C plan is most likely to experience which of the following outcomes when there are a high number of enrollees?

Answer 1

Favorable selection

Question 2

Reforms to PDPM primarily impacts what setting

Answer 2

Skilled Nursing facilities

Question 3

Part B medicare co-insurance for physical therapy is what % of the medicare fee schedule (also known as medicare allowable charges?

Answer 3

20%

Question 4

medicaid spend down refers to

Answer 4

an individual will have to cash pay for their custodial care until they qualify for medicaid

Question 5

most physical therapist generated charges in an acute care hospital are used primarily to determine productivity and may not even leave the building to be billed to Medicare . Why?

Answer 5

The hospital is paid based on DRG

Question 6

Which of the following populations fits best in the ACO payment model?
-a pt with longstanding DM including LE amputation
-a person experiencing chronic ongoing challenges with homelessness
-a person with a supportive family who undergoes total joint replacement

Answer 6

a person with a supportive family who undergoes total joint replacement

Question 7

the shared responsibility payment can be satisfied by all of the following except

Answer 7

a non-ACA compliant private insurance plan

Question 8

which of the following elements reflect the expected future healthcare buisness model
-care provided in office
-fee for service
-ongoing health management
-utilization managed within a care setting
-sick care

Answer 8

ongoing health management

Question 9

at what point did US private health insurance premiums and deductibles begin rising

Answer 9

before the ACA was passed