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HLTH 3050 Final Exam Study Guide ECU Health Policy Questions and Answers
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HLTH 3050 Final Exam Study Guide ECU Health Policy Questions and Answers
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HLTH 3050 Final Exam Study Guide ECUHealth Policy Questions and Answers
Social Determinants Of Health - Answer-Social conditions into which people are born
and that affect their daily lives and overall well-being as they move through life
Types of Social Determinants of Health - Answer-1. Access to high quality educational
opportunities*
2. Access to medical care
3. Access to social media and other technologies
4. Availability of community-based resources and opportunities for recreational activities
5. Availability of resources to meet daily needs
6. Culture
7. Language/Literacy*
8. Public safety
9. Residential segregation
10. Social norms and attitudes
11. Socioeconomic conditions*
12. Transportation options
What effect does social determinants of health have on health outcomes? - Answer-half
of all deaths are related to behaviors
health-related behaviors are strongly shaped by Income, Education, Employments
What role does policy and law play in social determinants of health? - Answer-1. Law
can be used to design and perpetuate social conditions that an have terrible physical,
mental, and emotional effects on individuals and populations EX: Jim Crow laws
2. Laws can be utilized as a mechanism thru which behaviors and prejudices are
transformed into distributions of well-being among populations
ex: black and whites use drugs at same rate, drug incarnation is higher among blacks.
3. can be determinative of health through under-enforcement.
ex:L laws not enforced for supportive housing
4. can be used to structure direct responses to health-harming social needs that result
from things like impoverish, illness, market failure, and individual behavior that harms
others
ex: EMTALA, funding for community clinics, individual behavior that harms others
states can regulate laws on sale of firearms and tobacco
Benefits - Answer-The list of services covered by the health insurance plan
ex. well visits, blood work, specific procedures, x-rays
Premiums - Answer-Annual fee paid by the beneficiary to the health plan
, Deductible - Answer-The amount of money you pay first, before your health insurance
to pay
cost sharing - Answer-Costs shared between the insurance company and the individual
seeking health care
Done in co-payments, co-insurance
beneficiary - Answer-Individual who buys health insurance
Co-payment - Answer-A set dollar amount the beneficiary must pay at time services are
rendered
Co-insurance - Answer-The amount of the bill that the individual must pay AFTER the
deductible is met
Ex. 90/10, 80/20, 70/30
What role do uncertainty and risk play in health insurance? - Answer-insurance
companies need to cover the cost of their expenditures
-uncertainty and risk lead to adverse selection
-insurance companies make more money when healthy people buy insurance policies
-unhealthy people have more healthcare costs.
-If health insurance costs are too high, insurance companies will raise the price of their
premiums
Why did MCO start to operate? What benefits do they have? - Answer-Rising
healthcare costs, No mechanisms for cost containment under fee for service. Insurance
comaanies cant control access and costs in the FFS
Benefits: Managed care integrates the provision and payment of health care services.
MC contains cost while providing necessary and high quality health care services.
Provides incentives to provide fewer services and less expensive care, while
maintaining quality
What is managed care? What are some characteristics? - Answer-Managed care
integrates the provision and payment of health care services
Characteristics- Defined package of benefits for a pre-set fee, services offered through
a network of providers who have contracts with the MCO, MCO choose what providers
are in their network and what services they can offer
What are some of the cost saving strategies employed by MCOs? - Answer-
Performance-based salary bonuses and withholds, Discounted fee schedule, Capitated
payment
Health Maintenance Organization(HMO) - Answer-Health maintenance organization
Plan that provides services for a fixed period on a pre-paid basis
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