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Health Care Delivery > Quizzes 1-4 > Flashcards

Quizzes 1-4 Flashcards

1
Q

The focus that Kaiser Permanente put on their Thrive campaign to link an image of Wellness with their name and organization is an example of _________

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 SWOT 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 what type of financing? Equity, Debt, or Neither?

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 (new business, new program, business expansion, etc)

A

Feasibility Study

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5
Q

Floral shops raising the prices of roses around Valentine’s Day and Mother’s Day is an example of?

A

Supply and Demand

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6
Q

True or False: Measuring the change in the number of new patients/new evaluations per month before a marketing campaign and comparing that number to after the campaign is run, is an example of a Break Even Analysis

A

False

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7
Q

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

A

Opportunity cost

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8
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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9
Q

An effective method of monitoring expenses and projecting revenues is ______

A

constructing an annual budget.

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10
Q

True or False: 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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11
Q

True or False: Premiums for PPO’s are higher than premiums for HMOs

A

True

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12
Q

When a patient is seen by the PT, the PT enters codes. The 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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13
Q

True or False: HMOs typically have lower out of pocket costs at the time of service than a PPO

A

True

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14
Q

As cost of an insurance policy increases, the comprehensiveness of service 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 a TKR, including surgery, hospitalization, and post-op 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 (80%) the insurer is responsible for paying.

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17
Q

True or False: Individuals with traditional Medicare, seen by a physical therapist while under Observational Status in a hospital, use part B medicare benefits.

A

True

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18
Q

True or False: All states expanded Medicaid under Healthcare Reform.

A

False

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19
Q

True or False: 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 is part ____ of medicare

A

B

22
Q

Hospital insurance, including inpatient is part ____ of medicare

A

A

23
Q

Medicare Drug benefit is part ___ of medicare

A

D

24
Q

Medicare advantage is part ___ of medicare

A

C

25
Q

Is custodial care a covered service under Medicare?

A

No

26
Q

Does the medicare therapy cap apply to all outpatient physical therapy settings?

A

Yes

27
Q

What are the elements of the Triple Aim?

A

Improved Health. Cost Containment, and Improved Healthcare

28
Q

CMMI is given wide authority to:

A

lower spending without reducing the quality of care, and improving the quality of care without increasing spending.

29
Q

A group of providers agreeing to collaborate on both cost and quality, in exchange for shared financial incentives is an example of

A

ACO

30
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 _____

A

Bundled Payments

31
Q

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

A

Non-financial incentives, Mandates, Financial Incentives

32
Q

What is the definition of value in value-based care?

A

Health outcomes achieved per dollar spent.

33
Q

What is the ultimate outcome if the goal of “value” is achieved in healthcare?

A

High patient outcomes and satisfaction

34
Q

Were deductibles, premiums, cost sharing, underinsured population, uninsured population rising or falling before ACA?

A

ACA

35
Q

What was not addressed by the ACA?

A

Underinsurance

36
Q

True or False: Subsidies are available to many Americans who buy health insurance through the Exchange under ACA

A

True

37
Q

True or False: Plans on the exchange are required under ACA to provide rehabilitation/habilitation services as a benefit

A

True

38
Q

What was least addressed by the ACA?

A

Cost

39
Q

What were alternatives for states in developing the health insurance exchange under ACA?

A

Develop/open their own exchange, let the government do it, work together with the government to do it.

40
Q

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

A

Medicaid enrollment

41
Q

True or False: A major healthcare overhaul is expected during the Biden administration

A

False

42
Q

True or False: One impact of the pandemic was an increase in state expenditures on Medicaid

A

True

43
Q

Which healthcare plan would have no premiums or cost sharing?

A

Medicare For All

44
Q

Sales taxes, car registration, and tobacco taxes are examples of a ______ tax

A

Regressive

45
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

46
Q

The Colorado Option has a structure similar to Medicare Part _____

A

C

47
Q

What requires hospitals to participate and is currently available on the Colorado Healthcare Exchange?

A

The Colorado Option

48
Q

The US Healthcare Expenditures compared to other countries shows the US spending more in everything except _________

A

Long Term Care

49
Q

The 2021 CMS Innovation Center Comprehensive Plan includes:

A

a focus on health equity

50
Q

The Economic Cost definition:

A

The impact on the cost of healthcare

Health Care Delivery (10 decks)

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