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MHA 707 Exam D Study Guide With 100% Verified Solutions
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MHA 707 Exam D Study Guide With 100% Verified Solutions
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MHA 707 Exam D Study Guide With100% Verified Solutions
Describe HC in America at turn of 20th century. CORRECT ANSWERS -Dr. had solo
practices
-Hospitals were nonprofits
-LTC services were at home
-Small businesses for medical devices and pharmaceuticals
-Surgeries improved
-Control of infectious diseases
Medical Tool Box CORRECT ANSWERS -Vaccines
-Medicine
-Surgery
American Medicine Association (AMA) CORRECT ANSWERS -Established education
requirements for MD
-Professionalized those in the healthcare workforce
-Research advances for diagnosis and treatment
-Industry providing healthcare supplies and therapeutics
-Classification and data collectors to evaluate performance
Blue Cross Blue Shield CORRECT ANSWERS -Employer-based insurance
-Hospital care for those in Dallas
-Community rating over experienced rates to set rates for products
WWII influence on Healthcare CORRECT ANSWERS -Caps were made on wages
which fostered employee-based systems to attract scarce workers
-Developed nationwide
-1940 became one company with 24 million members and grew to 92 million in 1960
Community Rating on Health Insurance CORRECT ANSWERS insurer using
community rating to set insurance premiums ignores any differences in expected costs
among insured groups or people, same across the board
Experience Rating CORRECT ANSWERS Rating system that bases insurance rates on
claims history
HIPAA (Health Insurance Portability and Accountability Act) CORRECT ANSWERS
Brings improvements for access, privacy standards,and standards for EHC transfer to
improve efficiency and privacy
, Hill-Burton Act CORRECT ANSWERS the "Hospital Survey and Construction Act"
enacted by Congress in 1946; this legislation provided federal money to determine the
need for more hospitals and to pay for their construction
What is EMTALA designed to do? CORRECT ANSWERS Prohibited dumping by
Medicare participating hospital with active emergency room
What are some major pressures on HC in the last 20th century? CORRECT ANSWERS
-Solo physician practice and single hospitals
-Increase in HC demand
-Population at 180 million
-More people can afford insurance
-Medicare/Medicaid
How did the financing and organization of HC change in later 20th century? CORRECT
ANSWERS -Expansion on capitation and increase in Managed Care
-Increase in vertical and horizontal integration of health care
-Increase of for-profit healthcare org
Capitation CORRECT ANSWERS System of payment used by managed care plans in
which physicians and hospitals are paid a fixed, per capita amount for each patient
enrolled over a stated period regardless of the type and number of services provided;
reimbursement to the hospital on a per-member/per-month basis to cover costs for the
members of the plan
Fee-for-service (FFS) CORRECT ANSWERS set of fees for services established by a
health care provider and paid for by the patient
Value Equation CORRECT ANSWERS value = quality/cost
Modified Value Equation CORRECT ANSWERS Value= outcome/cost
Outcome: quality, efficacy, safety
Cost: resource tallies
What is the impact on Value if changes occur in quality, cost, efficacy, safety, etc?
CORRECT ANSWERS Success depends on the success of the enterprise (leads to
behavior changes and following protocols and formularies)
Crowding out CORRECT ANSWERS Substitution of private funds that otherwise would
have been spent on HC
NHI (National Health Insurance) CORRECT ANSWERS Single, countrywide healthcare
financing system ran by the government. This has been on the US agenda since 1912
with T. Roosevelt. Everyone in the population has insurance established by the federal
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