Test 2 Gov Involvement in Healthcare

Question 1

What are the purposes of union to guard the common good?

Answer 1

• defense
• economic welfare
• social well-being

Question 2

3 basic functions in health policy

Answer 2

• Identification
• Formation
• Implementation

Question 3

roles as a payer

Answer 3

• ensure adequate funding
• regulate health insurance market
• subsidize care for poor & disadvantaged

Question 4

Divisions for CMS

Answer 4

• Center for Medicare Management
• Center for Beneficiary Choices
• Center for Medicaid and State Operations

Question 5

ACA: insurance plan limits

Answer 5

• prohibited lifetime dollar limits
• no annual limits
• preventative services provided at no cost

Question 6

ACA: penalty for no insurance 2014

Answer 6

• 1% of household income
• $95 per person/yr (family max $285)
• whichever is greater

Question 7

ACA: penalty for no insurance 2016

Answer 7

• 2.5% of household income

- $695 per adult (max @ $2085)

Question 8

ACA: businesses on providing health insurance

Answer 8

• <25 full time employees w/ annual pay 50 employees working > 30 hours a week, require to provide health care; if not, have to pay tax

Question 9

ACA: Medicaid expansion

Answer 9

• include ages 19-65
• income up to 138% of FPL
• full federal assistance for first 3 years (90% after 2020)

Question 10

What are the disease states with the most frequent 30 day readmission?

Answer 10

• heart failure
• heart attack
• pneumonia

Question 11

ACA: Medicare part D prescription program

Answer 11

When patients reached the donut whole, it provided a 50% discount on negotiated brand name drugs

Question 12

Accountable Care Organizations (ACOs)

Answer 12

group of providers who are jointly held accountable for achieving measured quality improvements & reductions in rate of spending growth”