Week3-Ch2,MACRA,Reform

Question 1

Where should all revenue bills originate from? (origination clause)

Answer 1

House of Representatives

Question 2

T/F: Executive branch helps make laws?

Answer 2

False, they just interpret laws (and they can “craft” or request things)

Question 3

Does the executive branch create policy?

Answer 3

yes, establish rules and regulations to make the laws work

Question 4

Which judges are appointed for life?

Answer 4

federal

Question 5

first step of policy formulation stage?

Answer 5

agenda setting

Question 6

Federal legislative process: Bill must be introduced in which chamber? Then __ by special joint committee. Then passed by ___. Then signed or vetoed by ___

Answer 6

1. Both chambers house and senate
2. reconciled
3. Congress
4. President

Question 7

4 steps of federal legislative process

Answer 7

1. introduced in both chambers
2. Reconciled by joint committee
3. Passed as a joint bill by congress
4. Signed or veto by president

Question 8

What is tabling legislation

Answer 8

putting aside for later

Question 9

How many committees in House and how many in Senate?

Answer 9

House 14
Senate 24

Question 10

Medicare is under what department

Answer 10

Dept Health and Human Services DHHS/ HHS

Question 11

Policy modification occurs before/after implementation

Answer 11

after, once you see it in action and see what needs modifying

Question 12

What is cost shifting?

Answer 12

Private insurance dollars mean Medicare/Medicaid can pay less to hospitals etc. The private sectors subsidizes Medi/Medi

Question 13

What percentage of population is considered ‘rural healthcare’?

Answer 13

20%, or 60 million

Question 14

3 challenges to healthcare reform in US?

Answer 14

Obesity, Drugs, Rural healthcare

Question 15

What started Pay for Performance?

Answer 15

MACRA, passed after ACA- includes MIPS and APM

Question 16

2 programs under MACRA?

Answer 16

1. MIPS- Merit based incentive payments (adjust medicare payments to MDs based on a score) (CMS composite elements of score are: quality, practice improvement, interoperability of EHRs, costs)
   2.APM- alternative payment method (join group to work on specific issue for additional payment)

Question 17

What are 4 composite elements of CMS score used by MIPS?

Answer 17

1. quality
2. practice improvement
3. interoperability of EHR
4. costs

Question 18

T/F- MIPS has to remain revenue neutral?

Answer 18

True

Question 19

MIPS- what did physicians receive as reward or penalty?

Answer 19

+/- 7% bonus or penalty. There was a 9% penalty for not participating at all.

Question 20

What is an APM? name and purpose

Answer 20

Alternative Payment method. you can join a network that wants to work toward improving a specific issue and get an additional 5% on top of reimbursement

Question 21

What does MACRA stand for? what year?

Answer 21

Medicare Access and Chip Reauthorization Act- 2015

Question 22

What are Advanced APMs? Give example

Answer 22

More risk, more reward. Can get out of MIPS if you do this one. Ex: Comprehensive Kidney Care Tracking (disease management). Others targeted underserved group, or episode of care.

Question 23

What % of US spending is for chronic disease?

Answer 23

75%

Question 24

What % of Americans are obese?

Answer 24

40% (over age 20)

Question 25

Number of obese Americans is __ that of OECD countries?

Answer 25

twice, 200%

Question 26

Total healthcare costs are __% higher due to obesity

Answer 26

25%

Question 27

In 2016, what % of Americans used illicit drug?

Answer 27

10% (24 million)