1. The Donabedian Model includes all of the following except
a. Outcomes
b. Cost
c. Structure
d. Process
2. Fill in the missing step in the quality improvement journey: 1) Establish an aim; 2) link specific measures with the aim; 3) Establish operation definitions; 4)____________; 5) Analyze the data and sources of variation; 6) Turn the data into a strategy for actions
a. Data collection
b. Gather volunteers to participate
c. Implement an EMR
d. Make sure the aim will improve quality
3. Historically, why have payers limited choice of provider?
a. Control access
b. Control cost
c. Control quality
d. Make friends
4. One of the 6 attributes of an ideal health care delivery system is for providers (including nurses and other members of care teams) both within and across settings to have accountability to each other including reliable delivery of high-quality care. The attribute defined is
a. Easy access to appropriate care
b. Continuous innovations
c. Information continuity
d. Peer review and teamwork for high value care
5. P4P intent is
a. Rewards quality
b. Promote use of EMR
c. Promote evidence based medicine
d. All of the above.
6. Performance measures will vary because
a. Inputs to health care system vary
b. Patients are unique, different form others
c. Environments are different
7. The phenomenon called 'moral hazard' results directly from
a. health insurance coverage
b. inadequate payment to providers
c. managed care enrollment
d. the uninsured status of a segment of the U.S. population
8. Physicians and hospitals in the U.S. began consolidating and integrating mainly in response to
a. Increased government regulation
b. Pressures to contain costs
c. The growth of managed care
d. The demand for higher quality
9. Physicians are trained in ____________culture and hospitals exercise ________culture
a. Collective; expert
b. Expert; collective
c. Holistic; Scientific
d. Scientific; Holistic
10. Porter and Teisburg (2007) argue that competition in the U.S. healthcare system is not working because
a. Healthcare organizations are competing on levels that do not add value from the perspective of the consumer
b. Large healthcare organizations have a competitive advantage over small healthcare organizations.
c. Some healthcare organizations are for-profit and some are not-for profit
d. Third party payment distorts any chance to have a market driven system
11. A service is cost-efficient when:
a. The desired health outcome is achieved
b. The patient’s insurance plan saves money
c. The benefit received is greater than the cost incurred to provide the service
d. None of the above
12. Spending 16% of the GDP on healthcare is bad because
a. It is throwing the country into an economic recession
b. The value justifying the cost is not clear or known for all services provided
c. Total GDP is decreasing because of healthcare spending
d. All of the above
13. In technology assessment what role do clinical trials play?
a. They are used for experimentation with potentially useful drugs
b. They are used for establishing the rights of participants
c. They are used for determine cost-effectiveness
d. They are used for evaluating efficacy and safety
14. The U.S. healthcare system is
a. Fragmented
b. Disorganized
c. Inefficient
15. What is a PRO?
a. Price Rationing Organization
b. Political Review of Outcome
c. Peer Review Organization
d. President’s Review of Organizations
16. What was the main conclusion of the Rand Health Insurance Experiment
a. Cost sharing lowered health care utilization without any significant health consequences
b. Cost sharing lowered health care utilization but there were significant health consequences
c. Cost sharing did not affect health care utilization
d. Cost sharing increased health care utilization
17. What is the main function of the National Institutes of Health?
a. Conduct and support research on health care quality, cost, and access
b. Establish medical subspecialties in US medical schools
c. Provide specialized training for medical specialists
d. Conduct and support biomedical research
18. What main purpose do Clinical Practice Guidelines serve?
a. They ensure that services delivered are cost effective
b. They coordinate the delivery of health care between different practitioners
c. They assist practitioners in adopting a best practice approach
d. They provide incentives for using standard protocols
19. What is meant by the term “healthcare costs”?
a. The price of health care
b. How much a nation spends on health care
c. Cost of producing health care
20. What was the purpose of certificate of need (CON) laws
a. Monitor the diffusion of new technology
b. Control flow of federal funds for private projects
c. Control new health service programs
d. Control new construction and modernization projects.
21. Which central agency manages the healthcare delivery system in the United States?
a. Centers for Disease Control and Prevention
b. Department of Health and Human Services
c. Department of Commerce
d. None
22. Which of the following defines and acute healthcare model
a. Behavior Modification
b. Diagnose and treat
c. Health Risk Appraisal
d. Prevent Disease and Optimize well-being
23. Which of the following is a macro level factor influencing the patient/physician encounter rather than a micro level factor
a. Medical history
b. Patient’s insurance
c. Practitioner’s training and knowledge
d. Reimbursement structures.
24. Which of the following is not one of the 6 attributes of an Ideal Health Care Delivery System
a. Continuous innovation
b. Easy access to appropriate care
c. Peer review and teamwork for high-value care
d. Prepayment reimbursement methodology
25. Which of the following statements is true
a. The term e-health applies only to the electronic delivery of health care by qualified health care professionals.
b. The United States controls the diffusion of medical technology through central planning.
c. Evidence from other industrialized nations shows that limitations on the adoption and use of technology do not necessarily correlate with negative health status of a population.
d. The cost of acquiring technology has a greater impact on total health care expenditures than utilization of technology.
26. Which statement is false
a. According to polls, most Americans are satisfied with the quality of health care.
b. As healthcare delivery system developed in the U.S. it emphasized specialization over primary care.
c. Most Americans favor a government provided healthcare system
d. The number one concern about healthcare for Americans is the high cost
27. According to U.S. law, a non-profit organization
a. Can make only a limited amount of profit
b. Is tax-exempt
c. Cannot have a governing body
d. Must pay taxes only if they are profitable.
28. Advantages of for-profit organizations the followed except
a. Guaranteed an annual operating profit
b. Not subject to public fund restrictions
c. Profits may be distributed to shareholders
d. Value of investment may increase over time
29. Advantages of government ownership of facilities include all of the following but
a. Eligible to receive tax-deductible donations
b. Exempt for income taxes and property taxes
c. Financed through bonds rather than debt
d. Lesser amounts of oversight
30. All healthcare organizations are
a. Corporations
b. Exempt from anti-trust laws
c. Heavily regulated
d. Non profit
31. At a fundamental level, medical technology deals with
a. production of new equipment to provide more advanced health care.
b. the application of knowledge produced by biomedical research.
c. using discoveries made in basic sciences to improve health care.
d. new drugs and devices.
32. CPOE stands for
a. Clinical Provider Outcome Exception
b. Comparable Patient Outcome Effectiveness
c. Complementary Positive Outcome Effect
d. Computer Physician Order Entry
33. Current challenges against not-for-profit healthcare facilities include all but
a. Collection practices
b. Dumping of emergency patients
c. Low levels of charity care
d. Use of charitable assets
34. Determination of goals and objectives
a. Controlling
b. Coordinating
c. Organizing
d. Planning
35. Which of the following is a similarity rather than a difference between a private for profit and a private not for profit
a. Employees are private instead of public employees
b. Funding is through debt market rather than bond market
c. Solicitation of charitable contributions
36. Directors and officers of private facilities
a. Appoint Management
b. Are personally liable for facility debt
c. Have fiduciary duties only if investor owned
d. Must be employees of the private facility
37. In the U.S. the ratio of primary care physicians (broadly defined) to specialty physicians
a. 50/50
b. 90/10
c. 10/90
d. 40/60
38. Institutional theory predicts that
a. For-profit and non-profit organizations with imitate each other when faced with similar regulatory and legal constraints
b. As an enterprise increases in size, its unit overhead costs will decrease
c. As a hospital increases in size, its economies of scale dissipate
d. In competitive markets, both for-profit and non-profit organizations would deliver certain essential community benefits.
39. Investor owned hospitals
a. Do not have non owners on the board of directors
b. Do not offer tax incentives for charitable donations
c. Do not pay taxes
d. Do not provide charity care
40. Joint ventures between for profit and not for profit healthcare organizations
a. Are a means for allowing individual or private ownership of all or part of the not for profit.
b. Illegal
c. Legal if the assets of the not for profit do not benefit the for-profit partner
d. Violate the charitable purpose of the not for profit organization
41. Legislation that offer payments to healthcare organizations for meaningful use of an electronic medical record system
a. ERISA
b. HIPAA
c. HITECH
d. PPACA
42. Most home health organizations in the United States are
a. Private for profit
b. Private not-for-profit
c. Public for profit
d. Public not-for-profit
43. Most physician practices in the U.S. are
44. Non physician practitioners (NPPS) include
a. Osteopaths
b. Dentists
c. Physician Assistants
45. Not for profit healthcare facility means
a. The facility does not make a profit
b. The facility does not pay taxes
c. The facility is a public facility
46. Not for profit organizations are exempt from income tax because
a. They appoint community members as board members
b. They have a 501(c)3 designation from the IRS
c. They have a not-for-profit license from the state
d. They receive less in charitable donations than they make from operating revenues
47. States challenged the legality of the PPACA on the basis of
a. Fear businesses will move to other states because of lower healthcare costs for employees.
b. Feel HIPAA already covers the provisions offered in PPACA
c. Infringement of state powers
48. The aging of the American Baby-boomer population
a. Is expected to create more volume than the healthcare system can handle
b. Is expected to create a shortage of available healthcare workers
c. Is expected to shift more funding dollars into the private sector
49. Principle board functions do not include
a. Approving strategic direction
b. Approving capital budgets
c. Hiring and firing the CEO
d. Hiring and firing nursing staff.
50. Private healthcare facilities cannot be
a. Charitable or religious owned
b. For Profit
c. Government Owned
d. Not for Profit
51. Process organizations use to make important decisions, such as about mission, goals, capital financing, mergers, and quality improvement.
a. Accountability
b. EBMgmt
c. Governance
d. Management
52. RVUs reflect
a. Units of services delivered
b. Resource inputs
c. The dollar value of services
d. Coding of physician services
53. The difference in electronic record concept reflected in the terms EMR and EHR is
a. An electronic record reflecting baseline health readings (blood pressure, weight, etc) and an electronic record reflecting healthcare encounters (visits, procedures, etc).
b. An electronic record reflecting medical records within a single health delivery organization and an electronic record reflecting medical records inclusive of all providers and all locations.
c. An electronic record reflecting health records from ambulatory settings and an electronic record reflecting health from inpatient settings
d. An electronic record maintained by the patient and an electronic record maintained by the patient’s healthcare provider.
54. The Health Insurance Portability and Accountability Act requires
a. large health care organizations to switch to electronic health records.
b. protection of personal medical information.
c. nondisclosure of personal health information.
d. nontransmittal of individual health information over the Internet.
55. The number of healthcare jobs in the U.S. is estimated at about
a. 4 Million
b. 14 Million
c. 24 Million
d. 40 Million
56. The transfer and use of assets towards a charitable purpose is required
a. For operation of a for profit healthcare organization
b. For operation of a not for profit healthcare organization
c. For changing the status of a for profit healthcare organization to a not for profit healthcare organization
d. For changing the status of a not for profit healthcare organization to a for profit healthcare organization
57. There are approximately how many physicians practicing in the United States
a. 100,000
b. 180,000
c. 800,000
d. 8,000,000
58. VA Hospitals are an example of
a. Investor owned hospitals.
b. Private for profit hospitals
c. Private not for profit hospitals
d. Public hospitals
59. Verifying the identity of people who attempt to access information for an EMR
a. Authentication
b. Authorization
c. Encryption
60. Violating the rules of a 501(c)3 designation results in
a. Assessment of additional taxes on individuals receiving benefits from a not for profit organization
b. Assessment of additional taxes on the organization
c. Loss of 501(c)3 status
d. No penalty
61. What does ‘MUA’ stand for?
a. Metropolitan Utilization Area
b. Medically Underserved Area
c. Metropolitan Underserved Area
d. Medical Utilization Area
62. What financial benefit does a small rural hospital reap by qualifying for the designation ‘Critical Access Hospital’?
a. It can receive specific federal grants for serving vulnerable populations
b. It can use its beds for either acute care or long-term care as needed
c. It can increase its profitability by receiving special payments for emergency services
d. It can receive cost-plus reimbursement under Medicare Part A
63. Which of the following statements is true
a. Compared to other wealthy countries, the U.S. has too many physicians
b. Compared to other wealthy countries, the U.S. has too many specialists
c. Compared to other wealthy countries, the U.S. has too many hospital beds
d. Compared to other wealthy countries, the U.S. has a higher quality healthcare system.
64. Which of the following is not a basic managerial function
b. Governing
65. Which of the following sentences is false?
a. There is an imbalance between primary and specialty care services in the U.S. healthcare delivery system
b. Since 1980 there has been a decreasing number of international medical graduates
c. Specialists provide more complex services resulting in higher reimbursement
d. As the health care delivery system developed in the U.S. it emphasized specialization over primary care.
66. Which of the following statements is false?
a. Half of a healthcare organization’s costs are usually labor costs
b. Registered nurses undergo the same training as licensed practical nurses
c. An EMR system may eliminate the need for some healthcare support positions.
d. The number of nurses trained but not working would cover the current nursing shortage.
67. The Employee Retirement Income Security Act (ERISA) 1974
a. Exempts self-insured plans from certain mandatory benefits
b. Mandates that employers provide comprehensive health coverage benefits
c. Requires that low-income individuals be charged a lower premium
d. Outlawed discrimination in health insurance and retirement benefits.
68. Which of the following statements is true about midlevel providers?
a. Midlevel providers fill physician shortages in rural areas
b. Midlevel providers can bill at the same level as Hospitalists
c. Midlevel providers complete as much medical training as primary care physicians.
d. Midlevel providers must have a nursing background.
69. Which ownership type constitutes the largest group of hospitals and hospital beds in the United States?
a. Private for-profit
b. Federal government
c. Private non-profit
d. State and local government
70. Which type of health care facility employs the most healthcare workers?
a. Physician offices and clinics
b. Hospitals
c. Nursing and personal care facilities
d. None of the above.
