Deck 9: Financing Health Care and Health Insurance

Question 1

Private health insurance coverage includes all of the following, except:

A) PPOs.
B) HMOs.
C) Indemnity plans.
D) SNFs.
E) HDHPs.

Answer 1

D

Question 2

In purchasing health insurance, which of the following is not typically a consideration?

A) Benefit packages
B) Provider choice
C) Ethical issues
D) Coinsurance

Answer 2

C

Question 3

Which type of HMO offers the most flexibility for participating physicians?

A) Independent Practice Association
B) Closed-panel HMO
C) Open-panel HMO
D) Group-model HMO

Answer 3

A

Question 4

Access to the care of specialist physicians is limited in which of the following types of health plan?

A) Point of service plan
B) Conventional indemnity plan
C) Preferred provider organization
D) All of these are correct.
E) None of these is correct.

Question 5

The following are all public insurance programs, except:

A) Medicaid.
B) Medicare.
C) Children's Health Insurance Program.
D) All of these are public insurance programs.

Question 6

Medicare spending has increased as a result of which of the following?

A) The shift of treatment of patients to acute care settings
B) Growth in technology
C) Advances in the pharmaceutical industry
D) Increasing costs of medical malpractice
E) Growth in technology, advances in the pharmaceutical industry, and increasing costs of medical malpractice

Question 7

Medicaid spending increases are the result of which of the following?

A) Expansion of services of many types
B) Expansion of eligibility to include all children
C) Rising unemployment and increases in the uninsured
D) Expansions as a result of the Affordable Care Act
E) Expansion of services of many types, rising unemployment and increases in the uninsured, and expansions as a result of the Affordable Care Act

Question 8

Which of the following is true regarding many of those who are uninsured?

A) Workers who are employed in industries that do not provide health insurance
B) Do not have access to routine health care
C) Are American citizens
D) All of these are correct.

Question 9

Why should health care managers be concerned about health care financing and health insurance?

A) It's the right thing to do.
B) It's important to the organizations' bottom line and to organizational success.
C) Employees are concerned about the increases in their share of premiums and other cost sharing.
D) All of these are correct.

Question 10

Which of the following is characteristic of the way the uninsured utilize the health care system?

A) They utilize preventive care to maintain wellness.
B) They have a primary care physician.
C) They delay seeking care, eventually ending up in emergency rooms.
D) They can afford to pay for care out-of-pocket.

Question 11

Who bears the costs of providing care to the uninsured?

A) The uninsured
B) Philanthropic contributions
C) Local governments
D) Everyone

Question 12

A high-deductible health plan with a savings option represents a form of consumer-driven health plan that:

A) encourages the purchaser to be more aware of the cost of care.
B) encourages the consumer to use preventive types of health care.
C) is usually lower cost than other types of plans.
D) requires the consumer to pay a large amount out-of-pocket before the plan kicks in.
E) All of these are correct.

Question 13

Medicare includes coverage of all of the following, except:

A) inpatient hospital care under Part A.
B) mental health care under Part E.
C) prescription drugs under Part D.
D) physician services and outpatient care under Part B.

Question 14

The TRICARE military health care system provides coverage for:

A) active duty military personnel.
B) retired military personnel.
C) the families of active duty and retired military personnel.
D) All of these are correct.

Question 15

Problems associated with the care of active military personnel and retirees include all of the following, except:

A) access to care in rural areas.
B) access to medical centers in major metropolitan areas.
C) access to care for reservists and other temporary personnel.
D) All of these are problems associated with the of active and retired military personnel.

Question 16

CHIP is a program that provides health care for:

A) all children.
B) children covered by Medicaid.
C) children covered by Medicare.
D) children in low-income families who would not typically qualify under Medicaid.

Question 17

Individuals who have coverage under the Medicare Program include:

A) elderly individuals younger than 65 years of age.
B) those with end-stage renal disease.
C) those who are permanently disabled younger adults.
D) All of these are correct.
E) those with end-stage renal disease and permanently disabled younger adults.

Question 18

Quality is likely to be high for those covered by which of the following?

A) HMOs
B) PPOs
C) Indemnity plans
D) HDHPs
E) PPOs, indemnity plans, and HDHPs.

Question 19

For which of the following groups of low-income individuals does Medicaid provide coverage?

A) Those who receive Temporary Aid to Needy Families (TANF) assistance
B) Those who receive Supplemental Security Income (SSI) assistance
C) Those who are pregnant
D) Those who are elderly
E) All of these are correct.

Question 20

Which of the following laws has had a major impact on social insurance in the U.S.?

A) Social Security Act of 1965
B) Patient Protection and Affordable Care Act
C) Medicare Prescription Drug, Improvement, and Modernization Act
D) All of these are correct.
E) None of these is correct.

Question 21

Challenges to Affordable Care Act have included which of the following?

A) The authority of the federal government to provide tax subsidies to individuals
B) The authority of the federal government to mandate coverage
C) The requirements that certain benefits, such as contraception, are covered
D) All of these are correct.
E) Both the authority of the federal government to mandate coverage and the requirements that certain benefits, such as contraception, are covered

Question 22

Nursing homes, continuing care retirement communities, and home health care combined accounted for more than half of national health expenditures in 2016.

Question 23

Growth in health care spending does not have the effect of crowding out non-health-related types of goods and services.

Question 24

The Children's Health Insurance Program is a form of public health insurance coverage.

Question 25

Private health insurance accounted for slightly more than half of all expenditures for health care in 2016.

Question 26

Fee-for-service is a form of payment whereby an individual pays a fixed, pre-specified amount in exchange for services.

Question 27

Major medical health insurance coverage typically includes hospital coverage, but not related physician services.

Question 28

Moral hazard refers to the concept that the existence of insurance coverage provides an incentive for insured individuals to secure and use coverage for a known condition.

Question 29

Medicaid and Medicare are private insurance programs administered by the federal government.

Question 30

Provider choice is unlimited under all types of health insurance plans.

Question 31

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 created Part D of Medicare.

Question 32

The purposes of the Patient Protection and Affordable Care Act include expanding access to health insurance coverage, efforts to contain costs, and emphasis on prevention and screening, to name a few.

Question 33

Funding for the Medicare Program has increasingly been derived from cost sharing with beneficiaries.

Question 34

Elderly and disabled Medicaid beneficiaries account for less than half of program spending.

Question 35

Enrollment in Medicare has increased significantly as a result of the Affordable Care Act.

Question 36

Medicaid is a major funder of safety-net hospitals, health centers, and behavioral health care, but is not involved in supporting long-term care services.

Question 37

Medicare is experimenting with Accountable Care Organizations in an effort to reduce costs, while Medicaid is not involved in this.

Question 38

The Veterans Health Administration is one of the smallest health care systems in the U.S.

Question 39

The VA does not have programs that cover children with certain birth defects born to female Vietnam Veterans.

Question 40

Funding for the Department of Defense and VA health programs is derived from the President's request for an appropriation to Congress.

Question 41

Premium payments for individual health insurance plans reached more than $19,000 in 2018.

Question 42

The majority of the uninsured population is comprised of females.

Question 43

The Affordable Care Act has had little impact on the number of uninsured individuals in the U.S.

Question 44

All states expanded their Medicaid Programs as part of the Affordable Care Act.

Question 45

The Patient Protection and Affordable Care Act of 2010 called for changes that have had an impact on insurers, businesses, consumers, and health care providers.

Question 46

Explain the two key concepts relating to health insurance and why they are important.

Question 47

Explain how health care is paid for in the U.S.

Question 48

Differentiate between comprehensive and catastrophic health insurance policies.

Question 49

Differentiate between major medical and catastrophic health insurance policies.

Question 50

Explain, in your own words, what the difference is between health maintenance plans and preferred provider plans.

Question 51

Explain, in your own words, what the difference is between indemnity plans and preferred provider plans.

Question 52

Explain, in your own words, the differences between Part A and Part B of Medicare.

Question 53

Define Medicare Advantage Plans and how they differ from traditional Medicare.

Question 54

Explain who is covered under the Medicaid Program and how much each of these groups consume of Medicaid dollars.

Question 55

Explain, in your own words, who the uninsured are and why they lack coverage.

Question 56

Explain in your own words the impact that the Affordable Care Act has had on bringing the uninsured into coverage.

Question 57

Despite increased efforts to provide health insurance coverage, many people still are not covered. Explain why this occurs.