HMGT 3301 Exam #1, Questions with accurate answers, 100% accurate.
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Course
HMGT 3301
Institution
HMGT 3301
HMGT 3301 Exam #1, Questions with accurate answers, 100% accurate.
What are the 6 main issues with a multi-payer system?
(1) difficult for providers to track various health plans
(2) providers have to hire claim processors
(3) payments can be denied which forces rebilling
(4) balanc...
,What are the 3 missing dimensions of the U.S. HC system?
(1) planning
(2) direction
(3) coordination from a central agency
What are the 5 inefficiencies in the U.S. HC system?
(1) duplication
(2) overlap
(3) inadequacy
(4) inconsistency
(5) waste
What are the 2 primary objectives?
(1) access to HCS
(2) cost effective w/ quality standards
The U.S. leads the world in what 4 things?
(1) technology
(2) training
(3) research
(4) sophisticated institutions/products/processes
The Quad-Function Model is made up of what 4 things?
(1) financing
(2) insurance
(3) payment
(4) delivery
Employer-based health insurance
, private
Premium Cost Sharing w/ groups
Privately purchased health insurance
private
Government programs
public
Medicare (fed), Medicaid(fed+state), CHIP
List 3 special government groups
VA, Military, IHS
What are 2 reasons why employment-based insurance systems leave some people unemployed?
(1) small businesses cannot get group insurance at affordable rates and are unable to offer insurance
(2) participation in insurance program may be optional
What did the ACA do?
required all U.S. citizens and legal residents to be covered by public or private insurance
What 4 things make up Managed Care?
(1) seeks to achieve efficiency by integrating the functions
(2) controls utilization of services
(3) determines price
(4) payer is still employer or government
What is Managed Care?
an attempt to control utilization and manage the pricing established/volume of insurers
because traditionally the financier, insurer, provider and payer have been different entities
What are the 7 external forces affecting HC delivery?
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