Deck 12: Economics of Health Care

Question 1

Which of the following was a major change after Medicare began a prescription drug benefit?

A)Number of prescriptions ordered by physicians decreased
B)Medications increased without affecting patient care outcomes
C)U.S. expenditures on drugs approached the same level as that of other industrialized nations
D)Use of drugs and their cost immediately increased

Answer 1

Use of drugs and their cost immediately increased

Question 2

Which of the following conclusions can be drawn from reviewing how health care costs are spread over a person's lifetime?

A)Health care expenditures increase with age.
B)Premature newborns incur more costs than other children from birth through adulthood.
C)The majority of cost is incurred during middle age when chronic diseases strike.
D)Persons aged 85 years and above spend the most money on health care.

Answer 2

Health care expenditures increase with age.

Question 3

Which of the following actions would help decrease the total health care costs in the United States?

A)Consolidate major health care facilities while expanding neighborhood primary care clinics
B)Continue the move to computer-based medical records and other efficiencies in informatics
C)Decrease current fraud and abuse
D)Streamline and make more consistent all documents needed for third-party reimbursement

Answer 3

Decrease current fraud and abuse

Question 4

Which of the following best describes how the federal government determines which projects are awarded special funding for health care?

A) Those that are consistent with societal priorities, such as 2020 Health
B) Those that are supported by legislators
C) Those that are written by health care organizations that have special needs
D) Those that are consistent with the state’s long-term health goals

Question 5

A client living in the 1920s received health care services.Which of the following would have been the most likely form of payment?

A)Patients paid out of their pockets for whatever care the provider charged.
B)Public health employees gave care to those who needed it.
C)There was little health care to be had, regardless of a person's wealth.
D)Workers who belonged to a union had their bills paid by insurance.

Question 6

Why did employers decide to offer health insurance as an employee benefit?

A)Hospitals and physicians quit offering charity care to those who could not pay.
B)Society was focused on not having to pay for doctor visits and other needed health benefits.
C)Teachers were role models for unions to demand insurance as a benefit.
D)To obtain and retain the limited number of persons available to work when government rules prohibited raising wages, insurance was offered.

Question 7

Which of the following best describes how having health insurance has affected lifestyle behaviors?

A)Health promotion disease prevention programs are attended because they are reimbursable.
B)Health education is widespread, because insurance companies promote such education.
C)Medications and medical treatment are relied on for cure.
D)Screening is widespread because of insurance sponsorship.

Question 8

Which of the following best describes what happens when a health care organization receives federal funding for a special health care need?

A)Other groups see the project and write grants wanting similar projects in their geographic area.
B)Participants continue to demand the services so local funding has to be readjusted to continue the care.
C)Research is done to demonstrate whether or not the intervention was successful and should be replicated.
D)When funds cease, so does the health care; therefore, continuity is lacking.

Question 9

Which of the following statements best describes what happened to health care providers during the Great Depression?

A)The amount of charity care greatly increased.
B)Both hospitals and physicians went bankrupt.
C)Government funding was legislated to assist those in need.
D)Public health greatly expanded to care for those in need.

Question 10

Which of the following is the best definition of economics?

A)Assets that can be traded for different assets
B)Income and outgo of monies
C)Science of allocation of resources
D)Study of goods, services, talents, and transportation

Question 11

Which of the following best describes the first government step in trying to stop constantly rising costs?

A)Insurance companies were told to cease adding new members to their plan.
B)Payment reimbursement was based on diagnosis and client characteristics rather than on treatment given.
C)Physicians were limited to a maximum amount that would be paid for any particular service.
D)Reimbursement was based on prospective payment; that is, in advance of admittance for care.

Question 12

Which of the following best describes why so many Americans continue to engage in unhealthy behaviors?

A)Americans are not knowledgeable on how to change their behavior.
B)Americans believe that most illnesses can be cured with insurance footing the bill.
C)Health is not a concern to most Americans.
D)Most Americans do not know which behaviors are unhealthy.

Question 13

Which of the following best describes what was done by large industrial giants to stop the constant increase in their costs for health insurance for their employees?

A)Assembled their own health care programs
B)Established health promotion programs that employees were required to attend
C)Signed only certain providers to give care at a reduced rate in exchange for so many new patients
D)Suggested that employees seek only the most necessary services

Question 14

Which of the following best describes a current trend related to health care services?

A)Nonprofit organizations are assuming responsibilities for service from for-profit organizations.
B)Health care organizations are offering services low in cost and higher in reimbursement.
C)Ways to minimize reimbursement using current procedural terminology (CPT) codes have been created.
D)Postponing computerized medical record programs increases profitability.

Question 15

Which of the following best describes a flaw of indemnity plans?

A)Blue Cross and Blue Shield had a great idea, but they went bankrupt.
B)Cost sharing was expected of Blue Cross and Blue Shield enrollees.
C)Enrollees could not choose their provider or manage their own care.
D)Plans lacked any incentives to contain costs.

Question 16

Which of the following best describes what physicians did to compete with new competition from health maintenance organizations (HMOs)?

A)Accepted employment directly under the insurance company
B)Organized preferred provider organizations (PPOs) to negotiate with insurance companies
C)Created private practices with colleagues within hospital medical complexes
D)Decided to strike and refused to work in the new HMOs

Question 17

Which of the following actions would be the least expensive approach to treating chronic diseases?

A)Choose healthy lifestyle behaviors to retain health
B)Continue media campaigns encouraging early detection and treatment
C)Encourage patients to seek care at a local neighborhood health clinic
D)Suggest self-therapies that have been demonstrated to be effective

Question 18

Which of the following best describes the health care services that are provided by philanthropic groups?

A)Direct care to patients with problems related to the group's primary interest area
B)Legislative lobbying for increased funding for their special interests
C)Informational and research activities
D)Special services such as housing, transportation, or appearance aids

Question 19

Which of the following statements best describes a major event that occurred in the 1960s that affected health care?

A)The amount of charity care by health care providers greatly increased.
B)Hospitals began to voluntarily pay taxes to the communities where they were located.
C)Legislation greatly expanded funds available to train physicians, nurses, and other health care providers.
D)The Social Security Act was amended to create Medicare and Medicaid legislation.

Question 20

Which of the following statements best describes the message that public health leaders are trying to emphasize to the public?

A)Assume responsibility for your own health by choosing healthy behaviors
B)Have a primary physician and get yearly checkups
C)Obtain immunizations and screenings when they are offered
D)Support legislative efforts to improve our medical care system

Question 21

Which of the following best describes the effects of Medicare and Medicaid? (Select all that apply.)

A)All persons who were temporarily disabled now receive free care.
B)A previously unseen rise in demand for services occurred.
C)Many persons previously without access now receive health care.
D)Medicare reimbursement rates became the standard for all insurance carriers.
E)
Indemnity insurance plans were offered.
F)Public health education was now financed.

Question 22

Who may receive benefits under Medicare? (Select all that apply.)

A)Federal employees
B)Persons aged 55 to 65 years who have bought into the system
C)Persons with end-stage renal disease
D)Those over 65 years of age, if eligible for Social Security benefits
E)Those who are dependents of elderly grandparents, usually because their parents are in prison as a result of drug abuse
F)Those with permanent disabilities

Question 23

Which of the following best describes how hospitals initially coped when Medicare reimbursement became based on diagnosis-related groups (DRGs)?

A)Charged more for patients whose care was paid by insurance
B)Decreased nursing staff to cut labor costs
C)Lobbied politicians to increase Medicare reimbursement to reflect actual costs
D)Refused to accept Medicare patients

Question 24

Which of the following best describes the strengths of the American health care system? (Select all that apply.)

A)Offering the availability and use of technological advances in equipment and procedures
B)Having the ability to overcome concerns regarding access and rationing
C)Providing the highest quality of life among any industrialized nation
D)Having the lowest maternal and infant mortality rate among industrialized nations
E)Leading the world in laboratory and clinical research
F)Creating the best patient care outcomes

Question 25

Which of the following best describes how eligibility for Medicaid services is determined? (Select all that apply.)

A)Anyone over age 65 years who is eligible for Social Security benefits may apply for Medicaid.
B)Baseline eligibility is established by the federal government, but states may be more lenient.
C)Children in low-income families are eligible for free care.
D)Eligibility depends on family size and total family income.
E)Federal government establishes eligibility and gives funds to the states in reimbursement for this care.
F)State government establishes guidelines for whether to participate and who will be covered.

Question 26

Which of the following statements best describes what was unfortunate about the original private health insurance plans that were developed? (Select all that apply.)

A)Because providers were paid for any service they gave, it was economically advantageous for them to give as much care as possible.
B)Health care costs increased very rapidly.
C)Health education and health promotion interventions were not included in the idea of health insurance.
D)It was immediately seen how much profit could be made by owning or managing an insurance company.
E)Patients wanted any and all care that might help, regardless of how expensive it was.
F)There was no limit on what care could be sought and given.

Question 27

Which of the following statements best describes an unfortunate consequence of using diagnosis-related groups (DRGs)to determine reimbursement? (Select all that apply.)

A)Insurance companies had to greatly increase their funding from employers.
B)The incentive was to undertreat and underuse health resources.
C)Health care providers had to accept losses for each patient treated.
D)Health care providers learned to cheat the system.
E)Health care providers refused to accept more patients whose reimbursement was based on DRGs.
F)High quality of care was no longer assured.

Question 28

Which of the following best describes how providers can legally improve their profit under the current reimbursement process?

A)Accept more patients and work more hours so former high income is retained
B)Order the cheapest generic medications and treatments possible
C)Convince patients that they do not want expensive treatments
D)Practice conservatively to earn an incentive payment

Question 29

Which of the following best describes what insurance companies did to decrease their constantly increasing costs? (Select all that apply.)

A)Did not cover any illnesses that were diagnosed before the person (or his or her employer) purchased insurance
B)Limited coverage to only certain services, eliminating any that were experimental, nontraditional, or too costly
C)Reimbursed only the care that was requested by the patient's primary physician
D)Limited providing insurance to companies who hired mainly young, healthy persons
E)Required preapproval before expensive services were used
F)Ceased coverage on any person who used an exorbitant number of services, whenever possible

Question 30

Which of the following best describes a carve-out service?

A)A particular service that is offered only by a designated provider or group.
B)A particular procedure that receives limited reimbursement.
C)A particular treatment is not allowed within a particular diagnosis.
D)A particular prescription drug that is only available to those with certain conditions.

Question 31

When was the idea of national health care insurance first debated in the United States?

A)Clinton's 1992 presidential campaign as he attempted to achieve such a plan
B)During President Johnson's administration when Medicare and Medicaid were instituted in the 1960s
C)President Franklin Roosevelt's attempt to include health insurance in Social Security legislation in the 1930s
D)President Theodore Roosevelt advocated such national medical coverage in 1916

Question 32

Which of the following best describes why large employers would decide to self-insure?

A)To claim to offer more benefits to employees
B)To have more control over health care providers
C)To be more effective at keeping employees happy
D)To reduce administrative costs charged by insurance companies

Question 33

Which of the following statements best describes why nurses should be knowledgeable about health care funding?

A)To be able to be an effective employee for insurance companies
B)To be knowledgeable when media asks for opinions on some new legislation
C)To better serve as patient advocates in policy making for funding that provides appropriate care for the greatest good
D)To know how to write nursing notes that reflect higher reimbursement possibilities

Question 34

Which of the following statements best summarizes all of the changes resulting from attempts to control costs?

A)Conflict between providers, patients, employer, and insurance plans raged.
B)Costs were controlled, at least temporarily.
C)Demand for health care drastically dropped.
D)Most employers discontinued their insurance plans for employees.

Question 35

Which of the following best describes how the government was successful at containing costs?

A)The original legislation for Medicare and Medicaid had built-in cost controls.
B)Certificate-of-need requirements restricted provider overtreatment.
C)Utilization review determined appropriateness of care.
D)Prospective payments were based on diagnosis-related groups (DRGs).
E)Peer standard review organizations were effective watchdogs.