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Question 1 2.5 / 2.5 points With the growth of managed care, the balance of power in the medical marketplace swung toward: Question options: providers. the supply side. the demand side. more regulatio... n. Question 2 2.5 / 2.5 points _____ occurs when an experienced health care professional, such as a nurse practitioner, coordinates an individual's total health care. Question options: Case management Utilization review Gatekeeping Closed-panel utilization Question 3 2.5 / 2.5 points Under which payment method is a fee schedule used? Question options: Prospective payment Capitation Discounted fees Fee for service Question 4 2.5 / 2.5 points Under capitation, risk is shifted from the: Question options: insured to the employer. provider to the MCO. employer to the MCO. MCO to the provider. Question 5 2.5 / 2.5 points Maintenance rather than restoration of function is specifically the domain of _____ care. Question options: custodial restorative skilled nursing personal Question 6 2.5 / 2.5 points Hospital-based transitional care units must be certified as: Question options: an acute care hospital. a SNF. a NF. both SNF and NF. Question 7 2.5 / 2.5 points A managed care organization functions like a/an: Question options: provider. insurer. regulator. financier. Question 8 2.5 / 2.5 points Gatekeeping heavily depends on the services of a: Question options: primary care physician. case manager . disease consultant. nurse practitioner. Question 9 2.5 / 2.5 points Gatekeeping ______ secondary care services. Question options: bypasses encompasses the delivery of requires a referral for does not control Question 10 2.5 / 2.5 points What is the purpose of risk sharing with providers? Question options: It makes providers immune to costs. It makes providers cost conscious. It rewards providers for quality. It keeps insurance premiums low. Question 11 0 / 2.5 points Fee for service promoted: Question options: price controls. moral hazard. provider-induced demand. both moral hazard and provider-induced demand. Question 12 2.5 / 2.5 points In a closed-panel plan: Question options: no new physicians can be added to the plan. new enrollees are not accepted by the plan. the enrollee cannot switch from one plan to another. the enrollee is restricted to the providers on the panel. Question 13 2.5 / 2.5 points Which federal agency is responsible for overseeing the programs funded through the Older Americans Act? Question options: Administration on Aging Medicare Medicaid Department of Housing and Urban Development Question 14 2.5 / 2.5 points In long-term care case management, services of freestanding case managers are used in the _____ model. Question options: integrated care brokerage managed care consolidated Question 15 2.5 / 2.5 points Rehabilitation therapies often form an important component of: Question options: health-maintenance model of adult day care. personal care. services available at senior centers. skilled nursing care. Question 16 2.5 / 2.5 points In the term, managed care, "manage" refers to management of: Question options: utilization. premiums. risk. the supply of services. Question 17 0 / 2.5 points A facility that is certified as NF can: Question options: admit only Medicaid patients. admit only Medicare patients. admit both Medicare and Medicaid patients. only be a distinct part. Question 18 2.5 / 2.5 points In recent years, the quality of care in nursing homes has: Question options: decreased. increased. stayed the same. been unknown. Question 19 2.5 / 2.5 points _____ is cost-effective management of care for patients who have complex medical conditions. Question options: Case management Gatekeeping Utilization management Managed care Question 20 2.5 / 2.5 points Which is the largest payer for home health services? Question options: Medicaid Out-of-pocket funds Medicare Private insurance Question 21 2.5 / 2.5 points Which of the following is NOT considered a "New Morbidity"? Question options: Emotional disorders Drug and alcohol abuse Neighborhood violence Childhood leukemia Question 22 2.5 / 2.5 points What is Gross Domestic Product (GDP)? Question options: A measure of all the goods and services produced by a nation in a given year A measure of all the goods and services produced by a nation in a given year, divided by the population A measure of all the goods and services produced by a nation in a given year, minus the amount of money spent by the government A measure of all the goods and services produced by a nation in a given year, divided by the amount of money spent by the government Question 23 2.5 / 2.5 points What is the main reason for the lack of success of health care cost control efforts in the U.S.? Question options: Malpractice lawsuits Cost shifting by providers Dislike of the practice by consumers Growth of technology Question 24 2.5 / 2.5 points Which age group in the U.S. has had the highest average annual percent growth over the past 30 years? Question options: Over 85 65-84 45-64 25-44 Question 25 2.5 / 2.5 points What does "MUA" stand for? Question options: Metropolitan Utilization Area Medically Underserved Area Metropolitan Underserved Area Medical Utilization Area Question 26 2.5 / 2.5 points Which racial/ethnic group has the highest rate of low birth weight infants? Question options: White Black or African American Asian or Pacific Islander Hispanic Question 27 2.5 / 2.5 points Which legislation created the State Children's Health Insurance Plan (SCHIP)? Question options: Balanced Budget Act of 1997 State Children's Health Insurance Act of 1997 Kids First Act of 1997 Omnibus Reconciliation Act of 1997 Question 28 0 / 2.5 points Approximately what percentage of children under age 18 in 2011 was uninsured? Question options: 6% 10% 12% 15% Question 29 2.5 / 2.5 points Most uninsured adults are employed but are not covered because: Question options: their employer does not offer health benefits. they do not qualify because they do not work an adequate number of hours or have not been with the employer long enough. they cannot afford to pay their portion of the premium or purchase insurance on their own. Any of the above could be a reason. Question 30 2.5 / 2.5 points What are small area variations? Question options: Geographic variations in health care practice Demographic variations in health care practice Both a and b Neither a nor b Question 31 2.5 / 2.5 points What is a PRO? Question options: Price Rationing Organization Political Review of Outcomes Peer Review Organization President's Review of Organizations Question 32 2.5 / 2.5 points Which racial/ethnic group is growing the fastest? Question options: White Black or African American Asian or Pacific Islander Hispanic Question 33 2.5 / 2.5 points Which racial/ethnic group has the highest rate of uninsurance? Question options: White Black or African American Asian or Pacific Islander Hispanic Question 34 2.5 / 2.5 points What are administrative costs? Question options: Costs associated with management of the financing, insurance, delivery, and payment functions of health care Costs associated with financing and insurance only Costs associated with delivery and payment functions only None of the above Question 35 2.5 / 2.5 points Among women, which racial/ethnic group has the highest percentage distribution of AIDS? Question options: White, non-Hispanic Black, non-Hispanic Hispanic American Indian Question 36 2.5 / 2.5 points Medical cost inflation is influenced by all of the following factors EXCEPT: Question options: waste and abuse. increase in elderly population. decrease in uninsured. growth of technology. Question 37 0 / 2.5 points Which racial/ethnic group is least likely to drink alcohol? Question options: Asian or Pacific Islander Black or African American White Hispanic Question 38 2.5 / 2.5 points Why should rising health care costs be controlled? Question options: Americans have to forgo other goods and services when more is spent on health care. Unless we control costs, total health care expenditures will far exceed what they would be under free-market conditions. Both a and b Neither a nor b Question 39 2.5 / 2.5 points Which racial/ethnic group is least likely to use mammography? Question options: White Black or African American Asian or Pacific Islander Hispanic Question 40 0 / 2.5 points What is a major health challenge of the migrant population? Question options: Heart disease Cancer Infectious disease HIV/AIDS [Show More]

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