Question 1

What is the term that describes when employers collect insurance premiums, pool resources, and pay claims?&#10;A) pay for performance&#10;B) stewardship&#10;C) employee-centered insurance&#10;D) self-insured

Accepted Answer

Self-insured refers to a system where employers collect insurance premiums, pool resources, and pay claims themselves rather than purchasing insurance from a third-party provider.

Question 2

Healthcare providers can control demand for services through _____..&#10;A) access&#10;B) upcoding&#10;C) encouraging self-pay&#10;D) marketing

Accepted Answer

Access controls demand for services by limiting the number of people who can use them.

Question 3

If you code visits by profit and not by diagnosis, you can engage in an unethical practice called ______.&#10;A) coding creep&#10;B) profit building&#10;C) mixed coding&#10;D) coding by objective

Accepted Answer

Coding creep is an unethical practice in which a healthcare provider codes visits by profit rather than by diagnosis. This can lead to patients being overcharged for services and can also result in inaccurate medical records.

Question 4

The accountable care organization (ACO) was created to control costs and improve access to care. ACOs receive incentives for _____ .&#10;A) accepting short-term insurance&#10;B) HCAHPS scores&#10;C) coordination of care&#10;D) b and c

Accepted Answer

ACOs receive incentives for coordination of care and HCAHPS scores.

Question 5

Not-for-profit organizations have a duty to generate revenue and use that revenue for community benefit. The basis for this duty is in _____.&#10;A) Kantian ethics&#10;B) religious traditions&#10;C) social justice&#10;D) service to uninsured patients

Accepted Answer

Social justice emphasizes the fair distribution of resources and opportunities, aligning with the duty of not-for-profit organizations to use revenue for community benefit.

Question 6

Changes in Medicaid standards mean that they must decide how to allocate their limited resources and serve their state's needs. This issue creates an ethics issue related to _____.&#10;A) social justice&#10;B) political influence&#10;C) abuse&#10;D) staffing issues

Accepted Answer

The ethics issue related to changes in Medicaid standards and resource allocation is primarily about social justice, as it involves ensuring fair and equitable access to healthcare services for all individuals, particularly the underserved and vulnerable populations.

Question 7

An administrator is leading the downsizing process for his organization. This decision will lead to complete and permanent shutdown of the facility. His initial ethics duty for staff members is _____.&#10;A) providing a payout package&#10;B) transferring them to a new location.&#10;C) writing reference letters&#10;D) communicating honestly

Accepted Answer

The administrator's initial ethical duty is to communicate honestly with staff members about the downsizing process and its implications.

Deck 9: No Mission, No Margin: Fiscal Responsibility