MHA 707 Study Guide for Exam 3 (C)QUESTIONS & ANSWERS 100% ACCURATE!!
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Course
MHA 707 S
Institution
MHA 707 S
Other "truths" in motivating physicians behaviors include - ANSWER Employed doctors are easier to motivate than independent practitioners
Physicians identity themselves as "doctor" with a higher level of intensity than "your employee"
What is Asymmetry of information? - ANSWER A gap in know...
MHA 707 Study Guide for Exam 3
(C)QUESTIONS & ANSWERS 100%
ACCURATE!!
Other "truths" in motivating physicians behaviors include - ANSWER Employed doctors are easier to
motivate than independent practitioners
Physicians identity themselves as "doctor" with a higher level of intensity than "your employee"
What is Asymmetry of information? - ANSWER A gap in knowledge from person/group to another.
What is non-marketability of risk? - ANSWER inherent of medicine and medical practice
Moral Hazard - ANSWER behaving differently when you know someone else is taking the risk
(induced demand)
Adverse selection - ANSWER the sicker people likely want more insurance (the healthier the less)
Pooling risk - ANSWER sharing risk proportionately among many is a basic insurance concept
What is PHC? - ANSWER (a subset of HCE) includes all medical goods and services that are used to
diagnose, treat, and prevent health problems in a specific person.
Personal Health Care
How much $$ is spent on HC in US? Per capita and % of GDP? - ANSWER $3.49trillion,
17.9% GDP and
$10,739 per capita.
Financing health care in U.S. - ANSWER .Workarounds
,•Redundancies
•Contradictions
Percentage spent in hospitals? - ANSWER 33%- largest share of NHE
Percentage spent on Doctors? - ANSWER 26%- second highest share of NHE
Percentage spent on drugs? - ANSWER 9.5%-10.5%- third highest share of NHE
Chronic disease? - ANSWER defined broadly as conditions that last 1 year or more and require
ongoing medical attention or limit activities of daily living or both.
(i.e. heart disease, cancer, and diabetes)
What are "personal behaviors" and how do they fit into the leading causes of death? - ANSWER 10
leading CODs attributed to personal behaviors- Tobacco, obesity, poor diet, substance misuse/abuse.
90% 0f Americans have 1 risk factor, 52% have 2 or more
highest proportion in impoverished and racial/ethnic minorities
(NHEA) - ANSWER National Health Expenditure Accounts
National health expenditures (NHE) - ANSWER All health care consumption and investments in
medical structures and equipment and non commercial health services and biomedical research.
What percentage of NHE shares are spent on chronic disease? - ANSWER 90%- chronic conditions
are also considered some of the most preventable of all health conditions.
What percent of top utilizers account for 50% of spending in HC? - ANSWER 5% of top utilizers
(ambulatory and dental services)
, What are personal behaviors and how do they fit into the leading causes of death? - ANSWER Half of
the mortality from 10 leading CODs attributed to personal behaviors (i.e. tobacco use, obesity, poor
diet, substance misuse/abuse) most chronic disease
90% of americans have 1 risk factor - ANSWER 52% have 2 or more highest proportion in
impoverished and racial/ethnic minorities.
What percent of Americans were hospitalized in 2018? - ANSWER only 6.7% (about 7%)
How many US people are uninsured? - ANSWER 26.4M (~8% - creates big cost)
What portion of Americans under age 65 are covered by private health insurance? - ANSWER about
66% (about 8% of people under the age of 65 were uninsured/self pay in 2019)
What is cost-plus reimbursement? - ANSWER is how hospitals describe payment received for
services they have already provided plus additional percentage of those costs (includes built-in
profit)
Fee for service - ANSWER common method when the scope of work is clear to both sides (the oldest
form of payment - inefficiency costs the provider / Bad advice costs the patient) Provider centric
outcome
Capitation - ANSWER fixed prepayment per person to the health care provider for an agreed-on
array of services (per member/per month - PMPM) may put the physician at odds with the patient
What is value-based payment? - ANSWER most often used when value is easy to measure and
indisputable
[This is debatable! At least the goals are set in advance of the care given - usually]
(P4P - pay for performance)
MCO - ANSWER Managed care organizations- distinguishing feature of managed care is ability to
steer members to preferred providers, negotiate rates and manage utilization.
.United health group is the largest in 2017
Example of Managed Care Plans - ANSWER • Health Maintenance Organizations (HMO)
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