HSAD740 Midterm Exam

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HSAD740 Midterm Exam Chapters 1-8
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Question 1

Question
Administrative costs of the U.S. healthcare system account for what percent of total expenditures
Answer
  • a. 10%
  • b. 35%
  • c. 60%
  • d. No idea

Question 2

Question
52. The aging of the American Baby-boomer population
Answer
  • 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

Question 3

Question
53. Balance of physical, emotional, social, spiritual, and intellectual health
Answer
  • a. Ambulatory Care Sensitive Conditions
  • b. Optimal Health
  • c. Primary Prevention
  • d. Wellness Model

Question 4

Question
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.
Answer
  • a. Population Health Model
  • b. Social Ecological Models
  • c. Stages of Change Model
  • d. Wellness Model

Question 5

Question
The Clinton Health Plan Proposal in 1992 was the first defeated proposal for a national healthcare system.
Answer
  • True
  • False

Question 6

Question
56. Comparative international data on spending show that the U.S. health care system
Answer
  • 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.

Question 7

Question
57. Consumer Driven or Patient Focused care is about
Answer
  • 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.

Question 8

Question
58. Decline in numbers of Americans insured through employer sponsored plans is because
Answer
  • 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.

Question 9

Question
59. The defining criteria for a public good or service is
Answer
  • a. Cannot be excluded
  • b. Does not add additional costs for additional users
  • c. Both A & B
  • d. Neither A nor B

Question 10

Question
60. The Employee Retirement Income Security Act (ERISA), 1974
Answer
  • 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

Question 11

Question
61. Enforcement of policy, ensuring proper implementation of necessary services, and adequate crisis response
Answer
  • a. Access
  • b. Ambulatory care sensitive conditions
  • c. Assessment of public health problems
  • d. Assurance of public health problems

Question 12

Question
62. Which of the following government agencies administers the Family Medical Leave Act?
Answer
  • a. Administration for Children and Families
  • b. Department of Justice
  • c. Department of Labor
  • d. Social Security Administration

Question 13

Question
63. The federal government does not
Answer
  • 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

Question 14

Question
64. Which of the following geographic areas has the highest medical cost per capita
Answer
  • a. Montana
  • b. District of Columbia
  • c. New York
  • d. Texas

Question 15

Question
65. Government payments total what % of annual healthcare expenditures in 2007
Answer
  • a. 34%
  • b. 46%
  • c. 54%
  • d. 67%

Question 16

Question
66. Health care costs in the 1970s compared to projections of healthcare costs by 2019 show
Answer
  • 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

Question 17

Question
67. The largest growth area in projected healthcare jobs is in
Answer
  • a. Counselors
  • b. Physicians
  • c. Physician assistants
  • d. Registered Nurses

Question 18

Question
68. Healthcare expenditures are expected to grow what percent per year
Answer
  • a. 2.5%
  • b. 6.5%
  • c. 16.5%
  • d. 20.5%

Question 19

Question
69. Health Care Financing Administration was renamed
Answer
  • a. AHRQ
  • b. CMS
  • c. HRSA
  • d. NIH

Question 20

Question
70. The Health Insurance Portability and Accountability Act requires
Answer
  • 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.

Question 21

Question
71. Hospital care, physician and clinical services, and prescription drugs cost totaled what in 2009
Answer
  • a. $2.4 Trillion
  • b. $2.1 Trillion
  • c. $1.5 Trillion
  • d. $900 Million

Question 22

Question
72. If national health expenditures amount to 16% of the GDP, what does this mean?
Answer
  • 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.

Question 23

Question
73. Which of the following government agencies promotes widespread national adoption of health information technology
Answer
  • a. CMS
  • b. ODPHP
  • c. ONCHIT
  • d. SAMHSA

Question 24

Question
74. An international name for a government provided healthcare system is
Answer
  • a. Beveridge Model
  • b. Bismarck model
  • c. Mandated Insurance Model
  • d. National Health Insurance

Question 25

Question
Maine’s Dirigo Health Plan is different from other state plans because it
Answer
  • 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

Question 26

Question
To finance Medicare Part A,
Answer
  • 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

Question 27

Question
Which of the following is a similarity between the Medicare and the Medicaid population
Answer
  • 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

Question 28

Question
Medicaid saw a decline in beneficiaries in the 1990s because
Answer
  • 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.

Question 29

Question
Which of the following government agencies monitors nuclear safety of health programs?
Answer
  • Department of Defense
  • Department of Energy
  • Department of Homeland Security
  • Environmental Protection Agency

Question 30

Question
_____ reimbursement is based on the assumption that health care is provided in a set of identifiable and individually distinct units of services.
Answer
  • Bundled-fee
  • Cost-plus
  • Prospective
  • Fee-for-service

Question 31

Question
A set monthly or annual fee per enrollee.
Answer
  • Bundled fee
  • Charge
  • Capitation
  • RVU

Question 32

Question
The Department of Health and Human Services has ________ operating divisions
Answer
  • 2
  • 11
  • 12
  • 21

Question 33

Question
The Institute of Medicine reported that between 44000 and 98000 Americans die each year from
Answer
  • car accidents
  • medical error
  • suicide
  • Tuberculosis

Question 34

Question
The largest share of healthcare expenditures are for
Answer
  • Hospital
  • Long term care
  • Pharmaceuticals
  • Physician

Question 35

Question
The total requested budget of the DHHS is
Answer
  • $900 billion
  • $18 billion
  • $2 trillion
  • $9 trillion

Question 36

Question
The U.S. healthcare system is
Answer
  • 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

Question 37

Question
The United States spends about __________annually on healthcare
Answer
  • $900 million
  • $18 billion
  • $2 trillion
  • $9 trillion

Question 38

Question
The three core public health functions are
Answer
  • 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.

Question 39

Question
Under the fee-for-service system, providers had the incentive to
Answer
  • 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

Question 40

Question
What is gatekeeping?
Answer
  • 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

Question 41

Question
Which of the following falls on the Market Maximization side of the continuum?
Answer
  • Entrepreneurial
  • Mandated Insurance
  • National Health Insurance
  • National Health System

Question 42

Question
Which of the following government agencies funds health professions education programs
Answer
  • AHRQ
  • CMS
  • HRSA
  • NIH

Question 43

Question
Which of the following has the largest budget dollar allocation
Answer
  • Agency for Healthcare Research and Quality
  • Centers for Medicare and Medicaid Services
  • Food and Drug Administration
  • National Institutes of Health

Question 44

Question
Which of the following is not a function of Public Health
Answer
  • 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.

Question 45

Question
Which of the following is not an operational division of the DHHS
Answer
  • Administration on Aging
  • Administration for Children and Families
  • Indian Health Service
  • Office of Civil Rights

Question 46

Question
Which of the following statements is false
Answer
  • 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.

Question 47

Question
Which of the following is a true statement
Answer
  • 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.

Question 48

Question
Why was Medicare Part C created?
Answer
  • 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

Question 49

Question
[blank_start]Effectiveness[blank_end] defines the quality of the healthcare system, [blank_start]Efficiency[blank_end] defines the appropriate allocation of limited resources to achieve quality results, and [blank_start]Equity[blank_end] assumes distribution of healthcare services in a fair & equitable matter.
Answer
  • Effectiveness
  • Efficiency
  • Equity

Question 50

Question
Which of the following is not one of the 5As of the 5A Model of Intervention
Answer
  • ask
  • advise
  • alleviate
  • assist

Question 51

Question
Which of the following is not an influence of social determinants on health behavior and outcomes
Answer
  • 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

Question 52

Question
The U.S. Healthcare system can best be described as
Answer
  • Expensive
  • Fragmented
  • Market Oriented
  • All of the above

Question 53

Question
A healthcare system is evaluated by the three E’s.Which of the following is not one of the three E’s?
Answer
  • Effective
  • Efficient
  • Equal
  • Expensive

Question 54

Question
An example of a national health system within the U.S. is
Answer
  • Military
  • Medicare
  • Medicaid
  • All of the Above

Question 55

Question
Health Savings accounts are an example of
Answer
  • Market Maximization
  • Market Minimization
  • Mandated Insurance
  • National Health System

Question 56

Question
Most privately insured Americans gain healthcare insurance through
Answer
  • Government programs
  • Employee benefits
  • Individual purchase
  • Tax Payment

Question 57

Question
Which central agency manages the healthcare care delivery system in the United State?
Answer
  • Centers for Disease Control and Prevention
  • Department of Health and Human Services
  • Department of Commerce
  • None

Question 58

Question
Which of the following is not a true statement
Answer
  • 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.

Question 59

Question
Which factor below is a limiting factor on state’s ability to enact healthcare reform for their state.
Answer
  • 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.

Question 60

Question
Differences in language, culture, religion, healthcare beliefs, care-seeking behaviors, or educational levels that the healthcare delivery system fails to accommodate
Answer
  • i. Behavioral Risk Factors
  • ii. Health Assessment Impact
  • iii. Health Disparities
  • iv. Non economic barriers

Question 61

Question
26. Decline in numbers of Americans insured through employer sponsored plans is because
Answer
  • 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

Question 62

Question
Balance of physical, emotional, social, spiritual, and intellectual health
Answer
  • i. Ambulatory Care Sensitive Conditions
  • ii. Optimal Health
  • iii. Primary Prevention
  • iv. Wellness Model

Question 63

Question
Which of the following is a true statement about the Patient Protection and Accessible Care Act passed in March 2010
Answer
  • 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.

Question 64

Question
After full implementation of the Patient Protection and Affordable Care Act (ObamaCare)
Answer
  • 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

Question 65

Question
Why was SCHIP created?
Answer
  • 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
  • All of the above

Question 66

Question
Which major public insurance program was legislated in 1965?
Answer
  • medicare
  • medicaid
  • both a and b
  • neither a nor b

Question 67

Question
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?
Answer
  • i. Health Security Act
  • ii. Trade Adjustment Assistance Act
  • iii. Employee Retirement Income Security Act
  • iv. Health Insurance Portability and Accountability Act

Question 68

Question
19. The Employee Retirement Income Security Act (ERISA), 1974
Answer
  • 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

Question 69

Question
17. What is the primary mechanism that enables people to obtain health care services?
Answer
  • i. Availability of services
  • ii. Health insurance
  • iii. Payment for services
  • iv. Control of expenditures

Question 70

Question
16. Which of the following is not a behavioral risk factor?
Answer
  • i. Irresponsible motor vehicle use
  • ii. Inadequate physical exercise
  • iii. Unsafe neighborhoods
  • iv. Alcohol abuse

Question 71

Question
15. Which of the following factors is the leading cause of preventable disease and death in the United States?
Answer
  • i. High fat diet
  • ii. Heredity
  • iii. Smoking
  • iv. Unsafe sex

Question 72

Question
14. The wellness model is built on which of the following:
Answer
  • i. Intervention
  • ii. Adequate public health and social services
  • iii. Understanding risk factors
  • iv. All of the above

Question 73

Question
13. Which factor was the most instrumental in the growth of nonprofit community hospitals in the United States?
Answer
  • i. Hill-Burton Act
  • ii. Growth of private health insurance
  • iii. Medical technology
  • iv. Tax Equity and Fiscal Responsibility Act

Question 74

Question
12. From the early 1900s to the about 1970 the American Healthcare System was in which era
Answer
  • i. Cost Containment
  • ii. Growth
  • iii. Non Existent
  • iv. Quality and Outcome Reporting

Question 75

Question
11. The difference between longitudinal uninsured surveys and point in time uninsured surveys is
Answer
  • 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

Question 76

Question
10. Lack of insurance can result in:
Answer
  • i. Decreased utilization of lower cost preventive services
  • ii. Increased need for more expensive, emergency health care
  • iii. The spread of infectious disease
  • iv. All of the above

Question 77

Question
9. What is the primary reason that a segment of the U.S. population has been uninsured?
Answer
  • 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

Question 78

Question
8. Americans between the ages of 18 and 34 are uninsured because
Answer
  • 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.

Question 79

Question
7. Point of time surveys estimate the number of Americans over the age of 65 without insurance at
Answer
  • 1%
  • 5%
  • 10%
  • Unknown

Question 80

Question
6. Point of time surveys estimate the number of uninsured Americans at
Answer
  • i. 23 million
  • ii. 32 million
  • iii. 48 million
  • iv. 75 million

Question 81

Question
5. What is the most pressing concern that Americans have expressed about health care in the US?
Answer
  • i. Unavailability of timely services
  • ii. Increased power of managed care
  • iii. A large number of uninsured Americans
  • iv. High cost of health care

Question 82

Question
4. What is the meaning of the term ‘Access?’
Answer
  • i. All citizens have health insurance coverage
  • ii. Availability of services
  • iii. Employer-based health insurance
  • iv. Ability to get health care when needed

Question 83

Question
3. How has Medicaid created a two-tier system of medical care delivery in the US?
Answer
  • 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.

Question 84

Question
2. Which central agency manages the healthcare care delivery system in the United State?
Answer
  • i. Centers for Disease Control and Prevention
  • ii. Department of Health and Human Services
  • iii. Department of Commerce
  • iv. None

Question 85

Question
=On what grounds have middle-class Americans generally opposed proposals for a national health insurance program?
Answer
  • Higher taxes
  • government intervention
  • =Erosion of personal freedoms
  • =Cost of health care

Question 86

Question
9. What is an interest group?
Answer
  • 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

Question 87

Question
8. The biggest share of national health spending is used by
Answer
  • i. hospitals
  • ii. physicians
  • iii. prescription drugs
  • iv. nursing home care

Question 88

Question
________reimbursement is based on the assumption that health care is provided in a set of identifiable and individually distinct units of services.
Answer
  • i. Bundled-fee
  • ii. Cost-plus
  • iii. Prospective
  • iv. Fee-for-service

Question 89

Question
6. Under the fee-for-service system, providers had the incentive to
Answer
  • 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

Question 90

Question
5. Under retrospective reimbursement, a health care organization is paid according to
Answer
  • i. predetermined rates.
  • ii. the number of patients served.
  • iii. the costs incurred in operating the institution.
  • iv. fees established by the organization

Question 91

Question
4. The amount of reimbursement is delivered before the services are delivered.
Answer
  • i. Retrospective reimbursement
  • ii. Cost-plus reimbursement
  • iii. Prospective reimbursement
  • iv. Fee-for-service

Question 92

Question
3. Organized medicine
Answer
  • 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

Question 93

Question
2. What main purpose was served by an almshouse in the preindustrial period?
Answer
  • 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.

Question 94

Question
1. Which Statement is false
Answer
  • 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.

Question 95

Question
12. When patients have multiple health problems, this is called
Answer
  • i. Coaffliction
  • ii. Comortality
  • iii. Codependency
  • iv. Comorbidity

Question 96

Question
11. Which of the following statements is true?
Answer
  • 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.
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