Administrative costs of the U.S. healthcare system account for what percent of total expenditures
a. 10%
b. 35%
c. 60%
d. No idea
52. The aging of the American Baby-boomer population
a. Is expected to create more volume than the American 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
d. All of the above
53. Balance of physical, emotional, social, spiritual, and intellectual health
a. Ambulatory Care Sensitive Conditions
b. Optimal Health
c. Primary Prevention
d. Wellness Model
54. Behavior change models that integrate behavioral science with clinical and public health approaches by redefining what the targets of successful health interventions need to be in the context of individual and of social factors.
a. Population Health Model
b. Social Ecological Models
c. Stages of Change Model
The Clinton Health Plan Proposal in 1992 was the first defeated proposal for a national healthcare system.
56. Comparative international data on spending show that the U.S. health care system
a. Has the highest dollar spending but not the highest percent of GDP
b. Has the highest GDP but not the highest dollar spending
c. U.S. healthcare costs grow at a more rapid pace than other OECD countries.
d. During the managed care era (1980-2000) the rate of growth in the U.S. healthcare system dipped below the rate of other OECD countries.
57. Consumer Driven or Patient Focused care is about
a. Healthcare providers treating patients nicer
b. Patients actively involved in their healthcare decisions
c. Protection of medical information
d. Providing every medical service possible for each patient.
58. Decline in numbers of Americans insured through employer sponsored plans is because
a. Employers are shifting costs to employees to discourage over-utilization of healthcare services.
b. More individuals are buying individual coverage so as not to be locked to a single employer
c. The aging of the American population created a decrease in jobs during the first decade of the 21st century.
d. The economic downturn resulted in a loss of jobs and/or employee benefits.
59. The defining criteria for a public good or service is
a. Cannot be excluded
b. Does not add additional costs for additional users
c. Both A & B
d. Neither A nor B
60. 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
61. Enforcement of policy, ensuring proper implementation of necessary services, and adequate crisis response
a. Access
b. Ambulatory care sensitive conditions
c. Assessment of public health problems
d. Assurance of public health problems
62. Which of the following government agencies administers the Family Medical Leave Act?
a. Administration for Children and Families
b. Department of Justice
c. Department of Labor
d. Social Security Administration
63. The federal government does not
a. Operate healthcare facilities for veterans
b. Provide tax incentives to employers for providing employee healthcare insurance
c. Support the training of doctors and other health care providers
d. Treat all healthcare insurance premiums as tax deductible
64. Which of the following geographic areas has the highest medical cost per capita
a. Montana
b. District of Columbia
c. New York
d. Texas
65. Government payments total what % of annual healthcare expenditures in 2007
a. 34%
b. 46%
c. 54%
d. 67%
66. Health care costs in the 1970s compared to projections of healthcare costs by 2019 show
a. A growth in GDP from 7% to 19%
b. A growth in GDP from 11% to 25%
c. Total spending growth from $1T to $3T
d. Total spending growth from $2T to $4T
67. The largest growth area in projected healthcare jobs is in
a. Counselors
b. Physicians
c. Physician assistants
d. Registered Nurses
68. Healthcare expenditures are expected to grow what percent per year
a. 2.5%
b. 6.5%
c. 16.5%
d. 20.5%
69. Health Care Financing Administration was renamed
a. AHRQ
b. CMS
c. HRSA
d. NIH
70. 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.
71. Hospital care, physician and clinical services, and prescription drugs cost totaled what in 2009
a. $2.4 Trillion
b. $2.1 Trillion
c. $1.5 Trillion
d. $900 Million
72. If national health expenditures amount to 16% of the GDP, what does this mean?
a. The growth in total health care expenditures is 16%.
b. Domestic production of health care products and services has increased by 16%.
c. Health care costs are 16% of the total revenues in the health care industry.
d. Health care consumes 16% of the total economic production.
73. Which of the following government agencies promotes widespread national adoption of health information technology
a. CMS
b. ODPHP
c. ONCHIT
d. SAMHSA
74. An international name for a government provided healthcare system is
a. Beveridge Model
b. Bismarck model
c. Mandated Insurance Model
d. National Health Insurance
Maine’s Dirigo Health Plan is different from other state plans because it
Is funded entirely by employers within the state
Lowers provider reimbursement as more individuals enroll under the assumption that provider bad debt decreases with increased enrollment.
Offers coverage to low income individuals who otherwise are not covered by the state’s Medicaid plan
Replaces the state’s Medicaid plan
To finance Medicare Part A,
enrollees are required to pay a subsidized premium
only employers are required to pay a payroll tax
all income earned by a working person is subject to Medicare tax
employee wages are taxed up to a certain ceiling that is raised each year
Which of the following is a similarity between the Medicare and the Medicaid population
Eligibility criteria
Provision of health insurance to segments of the population not likely to be covered by employer provided insurance.
Requirement of beneficiary premiums for physician service coverage
Use of managed care systems to control costs
Medicaid saw a decline in beneficiaries in the 1990s because
Aid to Families with Dependent Children no longer required enrollment for Medicaid benefits
Average household incomes increased making less people eligible for Medicaid
Coverage of illegal immigrants by a national program within the Department of Homeland Security
Growth in the employer sponsored insurance market segment.
Which of the following government agencies monitors nuclear safety of health programs?
Department of Defense
Department of Energy
Department of Homeland Security
Environmental Protection Agency
_____ reimbursement is based on the assumption that health care is provided in a set of identifiable and individually distinct units of services.
Bundled-fee
Cost-plus
Prospective
Fee-for-service
A set monthly or annual fee per enrollee.
Bundled fee
Charge
Capitation
RVU
The Department of Health and Human Services has ________ operating divisions
2
11
12
21
The Institute of Medicine reported that between 44000 and 98000 Americans die each year from
car accidents
medical error
suicide
Tuberculosis
The largest share of healthcare expenditures are for
Hospital
Long term care
Pharmaceuticals
Physician
The total requested budget of the DHHS is
$900 billion
$18 billion
$2 trillion
$9 trillion
The U.S. healthcare system is
A Market Maximization System
A Market Minimization System
A mix of many different systems, some market maximization/some minimization
A blended single system of market maximization and market minimization
The United States spends about __________annually on healthcare
$900 million
The three core public health functions are
Assurance, policy development and detection of disease
Policy development, prevention of disease and assurance
Assessment, detection of disease and policy development.
Assessment, policy development, and assurance.
Under the fee-for-service system, providers had the incentive to
deliver more services than what would be medically necessary because a greater volume would increase their incomes
use less technology because they could increase their incomes by not using costly procedures
discriminate cost increases because they could get paid whatever they would charge
increase the level of quality in order to attract more patients
What is gatekeeping?
The process by which patients are denied needed care
The process by which primary care physicians refer patients to specialists
The concept that specialists use more diagnostic tests than primary care physicians
The idea that patients should be allowed to choose their own doctors
Which of the following falls on the Market Maximization side of the continuum?
Entrepreneurial
Mandated Insurance
National Health Insurance
National Health System
Which of the following government agencies funds health professions education programs
AHRQ
CMS
HRSA
NIH
Which of the following has the largest budget dollar allocation
Agency for Healthcare Research and Quality
Centers for Medicare and Medicaid Services
Food and Drug Administration
National Institutes of Health
Which of the following is not a function of Public Health
Activities to protect the environment
Building Community Hospitals for underserved areas
Making sure water supplies, restaurants, and food supplies are safe
Providing preventive health services, such as vaccinations.
Which of the following is not an operational division of the DHHS
Administration on Aging
Administration for Children and Families
Indian Health Service
Office of Civil Rights
Which of the following statements is false
In national health care programs, governments are immune from lawsuits
Since the beginning of the20th century, national health insurance efforts have pushed the healthcare system towards the market minimization end of the continuum.
A large number of elderly Americans are uninsured even though the government offers an insurance program for the elderly
A large number of low income Americans are uninsured even though the government offers an insurance program for the poor.
Which of the following is a true statement
Medicaid recipients are classified as medically uninsured.
Under the Medicare program, eligibility criteria and benefits are consistent throughout the U.S.
Part D of Medicare does not require the payment of a premium
Most long term care services for the elderly are covered under Medicare.
Why was Medicare Part C created?
To add a prescription drug benefit to the Medicare program
To channel beneficiaries into managed care programs
To provide services to children up to the age of 19
To extend benefits to people with end-stage renal disease
defines the quality of the healthcare system, defines the appropriate allocation of limited resources to achieve quality results, and assumes distribution of healthcare services in a fair & equitable matter.
Which of the following is not one of the 5As of the 5A Model of Intervention
ask
advise
alleviate
assist
Which of the following is not an influence of social determinants on health behavior and outcomes
Education and income affect health regardless of ethnic group
Genetic factors in African Americans results in lower health status
Mortality decreases with every increase in income and social/occupational rank
Spirituality helps patients cope with disease
The U.S. Healthcare system can best be described as
Expensive
Fragmented
Market Oriented
All of the above
A healthcare system is evaluated by the three E’s.Which of the following is not one of the three E’s?
Effective
Efficient
Equal
An example of a national health system within the U.S. is
Military
Medicare
Medicaid
All of the Above
Health Savings accounts are an example of
Market Maximization
Market Minimization
Most privately insured Americans gain healthcare insurance through
Government programs
Employee benefits
Individual purchase
Tax Payment
Which central agency manages the healthcare care delivery system in the United State?
Centers for Disease Control and Prevention
Department of Health and Human Services
Department of Commerce
None
Which of the following is not a true statement
Compared to other nations, the U.S. uses a larger share of its economic resources for health care.
Managed care decreased the rate of growth in health spending between 1993 and 2000.
Health care costs for the elderly are nearly 3 times more than those for the non-elderly.
Underutilization of health care services is not a problem in the U.S.
Which factor below is a limiting factor on state’s ability to enact healthcare reform for their state.
i. Most healthcare jurisdiction is granted to the federal government rather than the state government.
ii. States are concerned with driving employers to other states that have less demands on employers for financing social problems
iii. States are limited by federal laws such as EMTALA
iv. States do not have to balance their budgets.
Differences in language, culture, religion, healthcare beliefs, care-seeking behaviors, or educational levels that the healthcare delivery system fails to accommodate
i. Behavioral Risk Factors
ii. Health Assessment Impact
iii. Health Disparities
iv. Non economic barriers
26. Decline in numbers of Americans insured through employer sponsored plans is because
i. Employers are shifting costs to employees to discourage over-utilization of healthcare services.
ii. More individuals are buying individual coverage so as not to be locked to a single employer
iii. The aging of the American population created a decrease in jobs during the first decade of the 21st century.
iv. The economic downturn resulted in a loss of jobs and/or employee benefits
Balance of physical, emotional, social, spiritual, and intellectual health
i. Ambulatory Care Sensitive Conditions
ii. Optimal Health
iii. Primary Prevention
iv. Wellness Model
Which of the following is a true statement about the Patient Protection and Accessible Care Act passed in March 2010
i. All uninsureds will gain access to healthcare insurance
ii. Individuals and employers, with some exceptions, are mandated to have/offer healthcare insurance.
iii. Children can stay on a parents plan until they are married and have a family of their own.
iv. Government panels will determine how to ration healthcare services.
After full implementation of the Patient Protection and Affordable Care Act (ObamaCare)
i. All Americans will have health insurance
ii. An additional 32 million Americans will have health insurance
iii. Employers will no longer provide health insurance as a benefit
iv. All of the above
Why was SCHIP created?
To provide health insurance to the elderly who do not qualify for Medicare
To provide health insurance to low-income children who do not qualify for Medicaid
To provide health insurance to immigrants who qualify for neither Medicare nor Medicaid
Which major public insurance program was legislated in 1965?
medicare
medicaid
both a and b
neither a nor b
Which federal legislation has put severe constraints on the states to pass employer mandates that would require employers to pay for their employees' health insurance?
i. Health Security Act
ii. Trade Adjustment Assistance Act
iii. Employee Retirement Income Security Act
iv. Health Insurance Portability and Accountability Act
19. The Employee Retirement Income Security Act (ERISA), 1974
i. exempts self-insured plans from certain mandatory benefits
ii. mandates that employers provide comprehensive health coverage under their health insurance benefits
iii. requires that low-income individuals be charged a lower premium than those in high-income categories
iv. outlawed discrimination in health insurance and retirement benefits
17. What is the primary mechanism that enables people to obtain health care services?
i. Availability of services
ii. Health insurance
iii. Payment for services
iv. Control of expenditures
16. Which of the following is not a behavioral risk factor?
i. Irresponsible motor vehicle use
ii. Inadequate physical exercise
iii. Unsafe neighborhoods
iv. Alcohol abuse
15. Which of the following factors is the leading cause of preventable disease and death in the United States?
i. High fat diet
ii. Heredity
iii. Smoking
iv. Unsafe sex
14. The wellness model is built on which of the following:
i. Intervention
ii. Adequate public health and social services
iii. Understanding risk factors
13. Which factor was the most instrumental in the growth of nonprofit community hospitals in the United States?
i. Hill-Burton Act
ii. Growth of private health insurance
iii. Medical technology
iv. Tax Equity and Fiscal Responsibility Act
12. From the early 1900s to the about 1970 the American Healthcare System was in which era
i. Cost Containment
ii. Growth
iii. Non Existent
iv. Quality and Outcome Reporting
11. The difference between longitudinal uninsured surveys and point in time uninsured surveys is
i. The number of participants in the study
ii. The length of time the participant is uninsured
iii. The age grouping of the study participant
iv. The number of questions on the survey
10. Lack of insurance can result in:
i. Decreased utilization of lower cost preventive services
ii. Increased need for more expensive, emergency health care
iii. The spread of infectious disease
9. What is the primary reason that a segment of the U.S. population has been uninsured?
i. Medicare and Medicaid are the only public insurance programs
ii. The U.S. has a voluntary system of health insurance
iii. The poor cannot afford health insurance
iv. U.S. health insurance is dominated by managed care
8. Americans between the ages of 18 and 34 are uninsured because
i. They think they do not need insurance
ii. They are more likely to have lower paying jobs
iii. They are more likely to have part time/temporary jobs
iv. All of the above.
7. Point of time surveys estimate the number of Americans over the age of 65 without insurance at
1%
5%
10%
Unknown
6. Point of time surveys estimate the number of uninsured Americans at
i. 23 million
ii. 32 million
iii. 48 million
iv. 75 million
5. What is the most pressing concern that Americans have expressed about health care in the US?
i. Unavailability of timely services
ii. Increased power of managed care
iii. A large number of uninsured Americans
iv. High cost of health care
4. What is the meaning of the term ‘Access?’
i. All citizens have health insurance coverage
ii. Availability of services
iii. Employer-based health insurance
iv. Ability to get health care when needed
3. How has Medicaid created a two-tier system of medical care delivery in the US?
i. Many physicians do not serve Medicaid patients
ii. Only the poor are insured under the Medicaid program.
iii. Funding for the program is shared by both federal and state governments.
iv. The program is heavily regulated.
2. Which central agency manages the healthcare care delivery system in the United State?
i. Centers for Disease Control and Prevention
ii. Department of Health and Human Services
iii. Department of Commerce
iv. None
=On what grounds have middle-class Americans generally opposed proposals for a national health insurance program?
Higher taxes
government intervention
=Erosion of personal freedoms
=Cost of health care
9. What is an interest group?
i. A group of lawmakers within Congress with a particular area of interest
ii. A group of appointed judges with a particular political view point
iii. An independent, non-governmental group united by a policy area, which lobbies and advocates its point of view to lawmakers
iv. None of the above
8. The biggest share of national health spending is used by
i. hospitals
ii. physicians
iii. prescription drugs
iv. nursing home care
________reimbursement is based on the assumption that health care is provided in a set of identifiable and individually distinct units of services.
i. Bundled-fee
ii. Cost-plus
iii. Prospective
iv. Fee-for-service
6. Under the fee-for-service system, providers had the incentive to
i. deliver more services than what would be medically necessary because a greater volume would increase their incomes
ii. use less technology because they could increase their incomes by not using costly procedures
iii. indiscrimate cost increases because they could get paid whatever they would charge
iv. increase the level of quality in order to attract more patients
5. Under retrospective reimbursement, a health care organization is paid according to
i. predetermined rates.
ii. the number of patients served.
iii. the costs incurred in operating the institution.
iv. fees established by the organization
4. The amount of reimbursement is delivered before the services are delivered.
i. Retrospective reimbursement
ii. Cost-plus reimbursement
iii. Prospective reimbursement
3. Organized medicine
i. Concerted activities of physicians through the American Medical Association
ii. Affiliation of physicians with medical schools
iii. Standardized practice of medicine
iv. Unionization of physicians
2. What main purpose was served by an almshouse in the preindustrial period?
i. It was used to quarantine people who had contracted a contagious disease.
ii. It provided free medical care and drugs to ambulatory patients.
iii. It specialized in performing basic surgeries.
iv. It performed general welfare and custodial functions.
1. Which Statement is false
i. When hospitals first emerged in the United States, they were used primarily by the wealthy.
ii. In the preindustrial era, much of the medical care in the US was provided by nonphysicians.
iii. Pesthouses contained patients with a contagious disease from the general population.
iv. In the preindustrial era, barbers often functioned as surgeons.
12. When patients have multiple health problems, this is called
i. Coaffliction
ii. Comortality
iii. Codependency
iv. Comorbidity
11. Which of the following statements is true?
chronic condition is relatively severe, episodic, and often treatable.
ii. Generally, people with better education have higher incomes and better health status.
iii. Secondary prevention refers to rehabilitative therapies and the monitoring of health care processes to prevent complications or to prevent further illness, injury, or disability.
iv. The presence of an agent means that disease will occur.
