Question 5 (1 point) An understanding of the healthcare system has specific impl

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Question 5 (1 point)

An understanding of the healthcare system has specific implications for health services managers and policy makers due to the following:

Question 5 options:

a. Health service administrators need to understand their own organizational position within the macro-environment of the system.

b. New threats and opportunities can be better evaluated when the manager is knowledgeable about the dynamics of the macro-environment.

c. Managers are better able to evaluate the implications of health policy and reform proposals when they understand the relevant issues and how they are linked to healthcare delivery.

d. Healthcare leaders need to understand emerging trends in financing, insurance, payment and delivery of health care.

e. An understanding of rules and regulations application to a particular type of operation is not essential to a leader.

Answers a, b, c, and d

All of the above

Question 6 (1 point)

Select the two main aspect of the Supreme Court's ruling in lawsuits filled against the ACA of 2010 from the list below:

Question 6 options:

The court ruled against the majority of the ACA provisions - including the individual mandate - stating Congress does not have the power to implement this tax.

The Court ruled that the Federal Government could coerce states to expand their state Medicaid programs by threatening to eliminate funding for existing Medicaid programs in states that chose not to expand Medicaid coverage under the ACA.

The Court ruled that the Federal Government could not coerce states to expand their state Medicaid programs by threatening to eliminate funding for existing Medicaid programs in states that chose not to expand Medicaid coverage under the ACA.

The court ruled that the majority of the ACA provisions - including the individual mandate - were constitutional under Congress' power to tax.

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Question 7 (1 point)

True of False:

Medicare is a health insurance program for:

people age 65 or older,

people under age 65 with certain disabilities, and

people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).

Question 7 options:

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Question 8 (1 point)

True of False: Medicare Part A (medical insurance) covers doctor's services and outpatient care. Medicare Part B (hospital insurance) covers inpatient care in hospitals, critical access hospitals, and skilled nursing facilities.

Question 8 options:

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Question 9 (1 point)

Please select all the correct statements related to Medicaid Programs in Minnesota (Medical Assistance) and Minnesota Care from the list below:

Question 9 options:

Medical Assistance is Minnesota's Medicaid program for individuals with low incomes.

MinnesotaCare is a program for Minnesotans with low incomes that do not have access to affordable care coverage.

Medical Assistance does not require you to pay a monthly premium. Members have small co-pays for some services, usually $1 - $3. This is called cost sharing.

MinnesotaCare does require you to pay a monthly premium, and it is based on your income. Members have small co-pays.

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Question 10 (1 point)

True of False: The development of health services professionals in the US is closely related to population trends, advances in research and technology, disease and illness trends, and the changing environment of healthcare financing and delivery.

Question 10 options:

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Question 11 (1 point)

True of False

Question 11 options:

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Question 12 (1 point)

There are six main types of private health insurance options available to Americans. Select the six from the list below:

Question 12 options:

Self-insurance is an option chosen by many large employers who can generally predict their medical expenditures from year to year. Rather than pay insurers a premium to bear the risk, large employers can simply assume the risk by budgeting a certain amount to pay medical claims incurred by their employees. Self-insurance gives employers a greater degree of control over their health insurance costs. It is also exempt from several government regulations.

Group insurance - a plan obtained an employer, a union, or professional organization. Risk is spread over the entire group.

Medicare

Medicaid

Managed care plans, such as HMOs and PPOs, assume responsibility for the functions of financing, insurance, payment, and delivery.

Individually purchased private health insurance is an option available to the self-employed, the family farmer, the recent college graduate, the early retiree, and the employee of a business that does not offer health insurance. Individual private insurance determines premium price and eligibility based on the risk indicated by each individual’s health status and demographics.

High-deductible health plans combine a savings option with a health insurance plan carrying a high deductible; hence, premiums are lower than in other types of plans. Savings options give consumers greater control over how to use the funds. An HRA is funded solely by the employer; an HSA is established by the individual, is largely funded by the individual, and the account belongs to the individual.

Medigap is private health insurance available only to Medicare beneficiaries to cover mainly the cost-sharing expenses not covered by Medicare.

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Question 13 (1 point)

True or False: Value-based purchasing incorporates pay-for-performance (P4P) as a component in the reimbursement formulas used by Medicare to pay providers. The objective of P4P initiatives is to link reimbursement to quality and efficiency as an incentive to improve the quality of health care, as well as reduce system wide costs.

Question 13 options:

Question 14 (1 point)

True of False: Medicare reimbursement and cost-saving efforts of managed care are the two main factors that have led to a decline in hospital inpatient days and growth in ambulatory services. The PPS reimbursement based on DRGs provides hospitals with a strong incentive to minimize the inpatient length of stay and continue treatment in an outpatient setting.

Question 14 options:

Question 15 (1 point)

Select the main characteristics of primary care from the list below:

Question 15 options:

Referrals for specialized services are made by primary care providers.

Primary health care is regarded as essential health care.

Point of entry into the health services system.

Primary providers serve roles as: patient advisor, advocate, and system gatekeeper

A main function of primary care is to coordinate the delivery of health services between the patient and the system

Disparities across population subgroups be enhanced with primary care

Primary care focuses on one health issue.

a. Health service administrators need to understand their own organizational position within the macro-environment of the system.

b. New threats and opportunities can be better evaluated when the manager is knowledgeable about the dynamics of the macro-environment.

c. Managers are better able to evaluate the implications of health policy and reform proposals when they understand the relevant issues and how they are linked to healthcare delivery.

d. Healthcare leaders need to understand emerging trends in financing, insurance, payment and delivery of health care.

e. An understanding of rules and regulations application to a particular type of operation is not essential to a leader.

Answers a, b, c, and d

All of the above

Explanation / Answer

6) The two main aspects that supreme court's ruing in the lawsuits filed against the ACA of 2010 was the court ruled that the majority of ACA provisions - including the individual mandate-stating congress doesn't have power to implement the tax.The court held that the federal body should not force the states to expand their medical programs by threatening to eliminate funding for the medical programs which is existing in the states.So i think option A is correct.

7) Yes it is true.According to the US department of health and human services medicare is a health insurance program for the people who are at the age of 65 or older and under age of 65 with certain disabilities like permanent kidney failure and are supposed to go for dialysis.So i think the statement which is given in the question is TRUE.

8) No i think this is false because as per US department of health and human services, in the health insurance program,medicare,PART -A is health insurance and PART-B is medcal insurance.

10) Yes this is TRUE because all these factors are completely associated with the development of health services professionals in US.

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