Kahoot Review Flashcards

1
Q
Which of the following is not a type of cost sharing?
A. Premiums
B. Copayments
C. Coinsurance
D. Deductible
A

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
What type of insurance model is characterized by a contract between one payer and one physician?
A. Staff Model HMO
B. Group Model HMO
C. Network Model HMO
D. Preferred Provider Organization
A

B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
Which health profession helps patients achieve better functional independence by working on activities of daily living?
A. Speech-Language Pathologist
B. Physical Therapist
C. Occupational Therapist
D. Medical Assistant
A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
Which hospitals have provided the most consistent source of non-government funding for "charity care"
A. Religious not-for-profit
B. Secular not-for-profit
C. For-profit
D. Physician Owned
A

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
Which of the following is not a type of inpatient facility?
A. Assisted living facility
B. Inpatient rehab facility
C. Long term acute care hospital
D. Skilled nursing facility
A

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
Which group was not exempt from the ACA health insurance program?
A. Undocumented immigrants
B. Alaskan Natives
C. Those with a religious exemption
D. Those working for small employers
A

D

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

The Rand Health Insurance Experiment aligned with what major legislation?
A. Health Maintenance Organization Act
B. Medicare Prescription Drug, Improvement, and Modernization Act
C. Mental Health Parity Act
D. State Children’s Health Insurance Program

A

A

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

T/F Group/Staff HMO models gives insurers the most control over physician actions

A

True

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

Group model HMO

A

contract between one payer and one physician

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

Staff Model HMO

A

HMO owns health care facilities and employs physicians

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

Network Model HMO

A

HMO contracting with multiple physician groups

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

Independent Practice Association Model HMO

A

Physicians form their own organization and contracts with an HMO to provide services at a negotiated fee

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

Preferred Provider Organization

A

providers seek contracts with insurance

plans

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

Point of Service POS

A

pt required to choose a PCP within a network but can see out of network specialists

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

What are the three Tax-free bank accounts that can only be used for medical expenses

A

FSA
HSA
HRA

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

Define diagnostic related groups

A

group of ICD codes for reimbursement

17
Q

T/F capitation can be defined as reimbursement per patient per month

A

True

18
Q
Drugs given at a skilled nursing facility would be covered by?
A. Part D
B. Part A
C. Part B
D. Part C
A

B

19
Q

What did the discontinued medigap plans cover?

A

part B deductible

20
Q

T/F extra help (LIS) is determined by a benificiary’s income and resources

A

True

21
Q

What is a solution to moral hazard?

A

cost sharing

22
Q

what is a solution to adverse selection?

A

coverage limitations

23
Q

what is a solution to incentive to create loss?

A

capitated payment models

24
Q

what is a solution to supplier-induced demand?

A

prior authorizations

25
Q

what is the beveridge model?

A

health care provided by government via taxes

26
Q

what is the bismarck model?

A

non-profit insurance-based system financed by employers and employees

27
Q

what is the national health insurance model?

A

government run insurance payed with taxes provided by private employers

28
Q

Which countrie(s) use beveridge model?

A

UK

29
Q

Which countrie(s) use bismarck model?

A

germany, switzerland

30
Q

Which countrie(s) use national health insurance model

A

canada

31
Q

what is the out of pocket model?

A

patients pay for medical expenses out of pocket

32
Q

Which countrie(s) use out of pocket model?

A

china, south america