HSMT 3103 Exam 2

25 July 2022
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question
The phenomenon called "moral hazard" results directly from:
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Health insurance coverage
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In a general sense, what is the primary purpose of insurance?
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Protection against risk
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Under the DRG method of reimbursement, an acute care hospital is paid:
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A fixed amount for a particular DRG classification
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Which of the happen will happen with experience rating?
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Favorable groups pay a lower premium than high-risk groups
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Today, a majority of health insurance exists in the form of managed care plans.
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True
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The government plays a significant role in financing health care services in the United States.
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True
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What is gatekeeping?
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The process by which primary care physicians refer patients to specialists
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One reason women's health centers were created is:
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Women seek care more often than men
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The most prominent reason for the decline in the number of procedures performed in hospitals is:
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Most of these procedures were shifted to the outpatient setting.
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Which of the following is an example of a secondary care service?
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Rehabilitation
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Compared to tertiary care, primary care services are more complex and specialized.
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False
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There is little distinction between the terms "outpatient" and "ambulatory."
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True
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Which entity in hospital governance is legally responsible for the hospital's operations?
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The board of trustees/board of directors
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ALOS is an indicator of
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Severity of illness
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According to US law, nonprofit organizations:
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Are tax exempt
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When comparing hospital utilization and costs in the US with those of other developed countries, what is to be the greatest concern with hospitals in the United States?
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The cost of hospital stays
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The occupancy rate of hospitals in the United States began to decline in the mid-1980s.
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True
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Quality of health care is the main distinguishing factor between a general hospital and a specialty hospital.
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False
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What is the primary purpose of risk sharing with health providers?
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It can keep insurance premiums lower
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Antitrust legislation is intended to provide checks against:
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Anticompetitive behavior
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Under capitation, risk is shifted from:
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The MCO to the provider
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The biggest problem with fee-for-service was it incentivized providers to:
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deliver more services than what would be medically necessary because a greater volume would increase their revenues.
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In the 1990s, managed care was quickly credited for enabling small employers to offer health insurance coverage to their employers.
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False
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The majority of Medicaid beneficiaries and enrollees in Medicare Advantage plans receive health care services through managed care organizations.
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True
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Cognitive impairment puts an individual at a high risk for
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Functional decline
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In the delivery of long-term care, customized interventions are carried out according to:
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A plan of care
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What is the main goal of long-term care?
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Maintain function and prevent further decline
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Why is the assessment of psychiatric illness particularly difficult in geriatric patients?
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Comorbidities can obscure diagnosis.
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Facility licensing regulations are consistent nationwide.
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False
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In a skilled nursing facility, Medicare covers only short-term rehabilitation or convalescence.
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True