Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Health Policy > Exam 3 > Flashcards

Exam 3 Flashcards

(82 cards)

Start Studying
1
Q

What are the 2 broad categories of health disparities?

A

health STATUS disparities
health CARE disparities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which health disparity encompass disparities in health care access, quality, and outcomes?

A

health CARE disparities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which health disparity does the following define?:
“differences that occur by gender, race or ethnicity, education or income, disability, living in rural localities or sexual orientation”

A

STATUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which health disparity does the following define?:
“differences in the incidence, prevalence, mortality and burden of diseases and other adverse health conditions that exist among specific population groups in the united States. Research on health disparities related to socioeconomic status is also encompassed in the definition”

A

STATUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which health disparity does the following define?:
“racial or ethnic differences in the quality of healthcare that are not due to access-related factors or clinical needs, preferences, and appropriateness of interventions”

A

CARE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 3 measurement categories of health?

A

structural
process
outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is considered a difference in healthcare delivery?

A

clinical indications and patient preferences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is considered a disparity in healthcare delivery?

A

systemic factors such as resources or access and biases, stereotyping, and uncertainty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

______ is a tool to advance public health as well as define and enforce rights and responsibilities within the healthcare and public health systems.

A

law

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a situation in which everyone has the opportunity to attain his or her full health potential?

A

health equity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What part of medicare is for hospital/inpatient services?

A

part A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What part of medicare is for physician/outpatient services?

A

part B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What part of medicare is for managed care plans (Medicare Advantage)?

A

part C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What part of medicare is for prescription drug plans?

A

part D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which part(s) of Medicare has mandatory enrollment?

A

part A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which part(s) of Medicare has voluntary enrollment?

A

parts B, C, D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which part(s) of Medicare is financed through a mandatory 2.9% payroll tax?

A

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which part(s) of Medicare is financed through a general federal tax revenue?

A

B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which part(s) of Medicare is financed through annual deductibles?

A

B and D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which part(s) of Medicare is financed through parts A, B, and D?

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which part(s) of Medicare is financed through monthly premiums?

A

B and D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which part(s) of Medicare is financed through deductibles for each day of in-patient stay?

A

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which part(s) of Medicare is financed through hospital care after 60 days and skilled nursing facility care after 20 days?

A

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which part(s) of Medicare is financed by Medicare paying the insurance company a capitated rate for covering the beneficiary?

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Which part(s) of Medicare has a complicated cost-sharing structure that is known as the "doughnut hole"?
D
26
Which part(s) of Medicare is financed through a sliding scale of a small additional premium if income is more than $85,000/$170,000?
D
27
Which part(s) of Medicare provides some subsidies to help with premium and cost-sharing for those with incomes under 150% FPL with modest assets.
D
28
What is Medigap?
Supplemental insurance
29
Why would someone choose to have Medigap?
to cover out-of-pocket costs not covered by A and B
30
Does Medigap give you access to additional services or coverage?
no
31
Is Medigap a federally regulated plan?
yes
32
What is meany by "dual eligibles"?
When Medicaid helps pay for Medicare's premiums and cost sharing for Medicare beneficiaries with low income and modest assets.
33
What does MACRA stand for?
Medicare Access and CHIP Reauthorization Act
34
What prohibits Medicare supplemental insurance (Medigap) policies from covering the Part B deductible for people who become eligible for Medicare on or after January 1, 2020?
MACRA of 2015
35
Why was MACRA of 2015 put into place?
due to Moral Hazard
36
Which part(s) of Medicare provides comprehensive coverage that usually includes prescriptions?
C
37
Which part(s) of Medicare limits out-of-pocket spending?
C
38
Can you have both Medigap and Medicare Advantage?
no
39
Those enrolled in which parts of Medicare can also enroll in Medigap?
A and B
40
What are some services that are not covered under Medicare?
vision dental hearing aids/hearing exams nursing homes
41
Why might an individual select traditional Medicare over Medicare Advantage?
traditional Medicare does not vary based on geographic location
42
3 main "pathways" to Medicare eligibility.
- over 65 AND qualify for SS benefits - disability: must qualify for SS Disability Income AND have been collecting benefits for 24 months - diagnoses of ESRD, ALS, and receiving SSDI payments
43
To received Medicare eligibility, do you need to be a U.S. citizen or legal resident?
yes
44
Is long-term care covered with Medicare Part A?
no
45
There is a 10% __________ for each year a person is eligible but not enrolled in Part B.
penalty
46
Is Medicare free for the beneficiary?
no
47
Why might someone choose to have Medicare Advantage over traditional Medicare?
MA has more benefits, it it comprehensive coverage, and it allows you to budget.
48
How are nursing homes paid for in the US?
through Medicaid
49
What type of purchasing is the Medicare Reimbursement Policy moving toward?
value-based purchasing
50
What does it mean for Medicaid to be an entitlement program?
that the government is supposed to provide benefits to a certain population
51
How many low-income Americans does Medicaid cover?
1 in 5
52
As enacted, the ACA Medicaid expansion would cover adults up to ___% FPL in all states, filling long-standing gaps in coverage.
138
53
What is an exception to Medicaid coverage?
undocumented residents are not covered and states are not required to cover legal residents during first 5 years in the US.
54
What group of people does the federal government match funds for under Medicare?
pregnant women and children who are legal immigrants with less than 5 years of residency
55
What does EPSDT stand for?
early periodic screening diagnosis treatment
56
__________ benefits reflect the needs of the population that it serves.
Medicaid
57
What percentage of Medicaid spending is for long-term care?
40%
58
What are eligible individuals entitled to with Medicare?
a defined set of benefits
59
What are states entitled to under Medicare?
the federal government matching funds
60
What is the federal governments role under the federal-state partnership through Medicaid?
to set core requirements on eligibility and benefits
61
What is the states role under the federal-state partnership through Medicaid?
states have the flexibility to administer the program within federal guidelines
62
What percentage does the federal government pay for Medicaid?
57%
63
What percentage of the states budget does Medicaid take up?
17-20%
64
CHIP covers children under what age?
19 y/o
65
Is CHIP or Medicaid a more flexible program
CHIP
66
CHIP takes care of some of the gaps in what insurance plan?
Medicaid
67
Can children covered by CHIP be eligible for Medicaid?
no
68
Is CHIP an entitlement program?
no
69
Are the benefits for CHIP more or less defined than for Medicaid?
less
70
Is dental a required benefit for CHIP?
yes
71
________ has a higher FMAP called EFMAP.
CHIP
72
What population does CHIP try to cover?
the near poor
73
What are 3 reasons why states like CHIP?
- high match by the federal government - flexibility that it provides in coverage - ability to charge premiums
74
What are the 3 parts of the CHIP Congressional Intent?
- reduce the number of uninsured children - build on Medicaid but not as an entitlement - gives states flexibility
75
How does the enrollment and spending of CHIP compare to Medicaid?
much less
76
What services are optional with CHIP but not with Medicaid?
vision and hearing
77
What 3 things are federal funds allotted to states based on?
- recent CHIP spending - adjusted annually for child population growth - medical inflation
78
How many years does states have to spend each allotment for CHIP?
2
79
For CHIP, states that use allotted funds and exceed target enrollment are also eligible for what?
contingency fund payments
80
For CHIP, the federal government provides matching funds like Medicaid but federal funds are __________ for each state.
capped
81
There is reduced matching from the federal government for CHIP for covering children over ___% FPL
300
82
What are the top 2 reasons why families enroll their children in CHIP?
affordability health care need

Health Policy (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions