Deck 17: Health and Long Term Care Policy and Programs

Question 1

The largest expenditure from the Medicare Part A budget has generally been for:

A) home health care.
B) skilled nursing care.
C) hospital care.
D) physician services.

Answer 1

C

Question 2

Which of the following is true of Medicaid?

A) It must provide coverage for personal care services and community based services.
B) It offers basic hospital and optional supplementary insurance.
C) It is the main funder of nursing home care.
D) It covers medical care costs for all people aged 65+ years of age, and for disabled Social Security beneficiaries.

Answer 2

C

Question 3

The following groups have benefited from prescription drug reform except:

A) private insurance companies.
B) affluent elders.
C) low income elders earning less than $12,000 a year.
D) older adults needing approximately $4,000 worth of prescription drugs per year.

Answer 3

D

Question 4

A fundamental assumption characterizing current long-term care services is:

A) the public provision of services based on age and need.
B) individuals are first responsible for the costs of long-term care.
C) the importance of curing disease.
D) none of the above.

Question 5

Each of the following can provide long-term care services except:

A) adult day centers.
B) senior centers. .
C) assisted living facilities.
D) private homes.

Question 6

What percent of Medicare beneficiaries have no prescription drug coverage at some point each year?

A) 25%
B) 40%
C) 10%
D) 75%

Question 7

Barriers to effective transitions from one residential setting to another include all of the following except:

A) cultural differences.
B) poor communication.
C) resistance from family members.
D) health literacy issues.

Question 8

The primary factor underlying escalating health and long-term care costs is:

A) more people are reaching old age.
B) older people and their families are paying less for care.
C) older people's disproportionate utilization of hospital and physician services.
D) the growth of medical technology.

Question 9

Which of the following statements is true about the funding of the current long-term care system?

A) It provides an integrated and comprehensive system of both community-based and institutional options.
B) It finances an adequate level of home health care as a way to keep older people in their homes.
C) It is dominated by institutional care.
D) It is guided by a national policy on long-term care.

Question 10

As a whole, health and long-term care services for older people can be characterized by:

A) the growth of private insurance plans that fill the gaps left by public funding.
B) growing inequities and the creation of a two tier system of care.
C) greater emphasis on better quality of care in hospitals and nursing homes.
D) greater access to high tech diagnostic services for low-income elders.

Question 11

Home health care costs are:

A) mostly covered by Medicare.
B) primarily funded by state and local sources.
C) always lower than nursing home care.
D) publicly funded for skilled and unskilled services.

Question 12

The average expenditure for all health expenses for the population 65+ (including acute, chronic, long-term care) is ________ the cost for people under 65.

A) equal to
B) twice
C) three times
D) six times

Question 13

An older person's need for long-term care is generally determined by:

A) the number of medical conditions.
B) the severity of each medical condition.
C) problems in performing activities of daily living.
D) loss of cognitive skills.

Question 14

The way in which Medicaid is funded means that:

A) states must comply with federal regulations regarding which services to provide.
B) home health services , skilled nursing facility care and rural health clinics are optional.
C) most older people are covered by Medicaid.
D) it covers the difference between Medicare and out-of-pocket expenses for elders.

Question 15

Those most likely to purchase long term care insurance:

A) have children living nearby.
B) have serious pre-existing chronic conditions.
C) have a partner to protect.
D) have lower incomes.

Question 16

The largest expenditure from the Medicare Part B budget has generally been for:

A) home health care.
B) skilled nursing care.
C) hospital care.
D) physician services.

Question 17

The proportion of nursing home care that is paid by Medicaid:

A) is lower than the proportion paid by Medicare.
B) is lower than what is paid by private long-term care insurance.
C) is increasing due to population growth.
D) is increasing due to price increases by health providers.

Question 18

Medicare is designed to serve:

A) low-income older adults.
B) institutionalized persons.
C) older people with chronic disabilities.
D) all persons age 65 and over.

Question 19

Which of the following health care costs does Medicare not cover?

A) long-term nursing home care
B) home health care
C) hospital care
D) physician visits

Question 20

Older adults qualify for Medicaid in the following ways:

A) participation in SSI.
B) designation as medically needy.
C) dual eligibility for both Medicare and Medicaid.
D) all of the above.

Question 21

The goals of the Medicare Plus Choice Plan are cost-savings and quality of care.

Question 22

Home health care has been shown to be preferred by more older people than receiving care in a long-term care facility.

Question 23

Older persons comprise a majority of the total users of Medicaid.

Question 24

"Medigap" policies fill which of the following gaps in Medicare coverage?

A) Medicare deductible and co-payments
B) items and services not covered by Medicare
C) charges exceeding the amount approved by Medicare
D) all of the above

Question 25

Most long-term care services are covered by Medicare.

Question 26

A prospective payment system to limit payments in advance for a general course of treatment applies only to Medicare-reimbursed hospital care.

Question 27

The Program for the All-Inclusive Care for the Elderly (PACE):

A) focuses on only a small number of frail elders who are eligible for nursing home placement.
B) provides basic Medicare and Medicaid services.
C) combines primary with long term care.
D) all of the above.

Question 28

The need for long-term care will diminish for aging baby boomers because of a decline in chronic conditions compared to previous cohorts of elders.

Question 29

Fortunately, Medicare provides adequate health care protection for older Americans.

Question 30

Medicare is more likely to pay for hospital care, while Medicaid is the primary payer of nursing home services.

Question 31

The co-payment through Medicare coverage for mental health services is the same as it is for other services.

Question 32

Recently, the majority of funding for home health care comes from:

A) Medicare.
B) Medicaid.
C) private health insurance.
D) out-of-pocket.

Question 33

Medicare Advantage Organizations (MAOs) provide a major savings for Medicare.

Question 34

Medicare's major limitation for those with chronic illness is its limited coverage of:

A) hospitalization.
B) long-term care.
C) acute care.
D) home health care.

Question 35

Long-term care refers to a broad range of care for chronic conditions.

Question 36

Medicare Part B is financed through the Social Security payroll tax.

Question 37

Participation rates of eligible older adults are low in Medicaid.

Question 38

Researchers have shown that Medicaid spend-down requirements have been thwarted by many middle-class families.

Question 39

The number of proprietary home health agencies that are reimbursed under Medicare:

A) has declined sharply.
B) has declined slowly.
C) remained stable over the last 20 years.
D) increased dramatically.

Question 40

Cash and Counseling programs provide older adults with financial advice for long-term planning.

Question 41

The federal agency that that approves or denies Medicare claims is known as ________.

Question 42

What measures have attempted to reduce the costs under Medicare?

Question 43

________ allow beneficiaries to put Medicare dollars into a tax-exempt account to pay for qualified medical expenses.

Question 44

In what ways might older adults qualify for Medicaid?

Question 45

Distinguish between the services provided within home and residential care settings with those that are delivered in community-based settings.

Question 46

________ is a federal and state means-tested welfare program of medical assistance for the poor, regardless of age.

Question 47

Medicare beneficiaries now have supplemental insurance coverage, called ________, to help pay for additional health care costs, especially for the catastrophic costs of intensive care, numerous tests, or extended hospitalization.

Question 48

Explain the structural factors that underlie escalating health care costs.

Question 49

When an individual is eligible for both Medicaid and Medicare, they are said to be ________.

Question 50

Discuss the factors which have led to the growth in Medicare funded home care services.