Sample Questions and Answers
What does “cost-sharing” in health insurance refer to?
A. The amount of money the government contributes to a person’s healthcare costs
B. The total amount the insurance company is obligated to pay for a patient’s medical care
C. The portion of healthcare costs that the insured individual must pay, such as premiums, deductibles, and co-pays
D. A method of increasing the quality of care through shared decision-making
Answer: C
What is the “Chronic Care Model” focused on?
A. Treating acute health conditions as they arise
B. Improving care coordination for individuals with chronic conditions
C. Providing access to care for uninsured individuals
D. Reducing healthcare spending by eliminating long-term care
Answer: B
What is the main function of the “Centers for Medicare and Medicaid Services” (CMS)?
A. To regulate the cost of pharmaceuticals
B. To administer national health insurance programs like Medicare and Medicaid
C. To provide free healthcare to low-income individuals
D. To oversee the creation of new healthcare technologies
Answer: B
Which of the following is an example of a “pay-for-performance” healthcare model?
A. Hospitals are reimbursed based on the number of patients they treat
B. Providers are paid based on the quality and outcomes of the care they deliver, such as reduced readmission rates
C. Insurance companies set a flat fee for all medical services regardless of patient outcomes
D. Physicians receive bonuses for seeing a certain number of patients
Answer: B
What is “economic efficiency” in the context of healthcare policy?
A. Maximizing the number of patients served regardless of cost
B. Delivering healthcare services in the most cost-effective way while achieving the best possible health outcomes
C. Reducing the number of healthcare providers in the system
D. Prioritizing services that generate the most revenue for healthcare organizations
Answer: B
What does “Medicaid expansion” seek to achieve?
A. To reduce federal funding for Medicaid
B. To extend Medicaid coverage to more low-income individuals and families
C. To eliminate Medicaid as a government program
D. To limit Medicaid benefits to only children and pregnant women
Answer: B
Which of the following is a limitation of the U.S. healthcare system?
A. Universal access to healthcare services
B. High administrative costs and complexity
C. A single-payer system with a low cost to taxpayers
D. Equal healthcare access for all income groups
Answer: B
What does “uninsured rate” in a population refer to?
A. The percentage of people who are not eligible for healthcare services
B. The percentage of people who do not have health insurance coverage
C. The rate at which insurance premiums increase annually
D. The rate at which health insurance companies go bankrupt
Answer: B
Which of the following is a potential disadvantage of “capitation” in healthcare payment models?
A. Providers may have less incentive to manage patient care efficiently
B. Providers receive a set fee for each patient regardless of care needs, potentially leading to overutilization of services
C. Providers are rewarded for the number of patients they see, leading to an overuse of resources
D. Providers may cut back on necessary care to avoid financial loss if patient needs exceed the cap
Answer: D
What is the “Health Information Technology for Economic and Clinical Health” (HITECH) Act designed to do?
A. Regulate the pricing of medical devices
B. Promote the adoption of electronic health records and improve health IT systems
C. Provide free health insurance to low-income families
D. Increase the number of healthcare providers in rural areas
Answer: B
Which of the following would be considered an example of “market-driven healthcare reform”?
A. A government-imposed cap on healthcare spending
B. Encouraging competition among private health insurers to reduce costs and improve quality
C. Nationalized healthcare programs funded by tax revenue
D. Providing free healthcare services to all citizens
Answer: B
How does “telemedicine” contribute to healthcare access?
A. It allows patients to access healthcare services remotely, often reducing barriers related to distance or transportation
B. It eliminates the need for healthcare providers by using automated systems
C. It reduces the cost of healthcare services by eliminating office visits
D. It only applies to non-urgent care needs
Answer: A
What does “patient-centered care” emphasize in the healthcare system?
A. Treating patients as passive recipients of care directed by healthcare professionals
B. Involving patients in the decision-making process and ensuring that care is tailored to individual needs and preferences
C. Focusing solely on cost reduction in the healthcare delivery system
D. Providing care based only on clinical guidelines without considering patient input
Answer: B
What is “premium assistance” in health insurance?
A. A program that helps individuals pay their monthly premiums for insurance coverage
B. A program that provides free healthcare services to all patients regardless of income
C. A method of reducing co-pays for hospital visits
D. A government mandate requiring individuals to purchase private insurance
Answer: A
Which of the following is an advantage of “private health insurance”?
A. No out-of-pocket costs for services
B. More flexibility in choosing healthcare providers and treatments
C. Guaranteed coverage for all medical conditions
D. Government funding for all health insurance premiums
Answer: B
What is “healthcare rationing”?
A. Offering unlimited access to healthcare services regardless of need
B. Limiting access to certain healthcare services or resources due to budgetary constraints
C. Increasing the number of healthcare professionals to meet demand
D. Expanding access to care for all individuals
Answer: B
What is a “high-deductible health plan” (HDHP)?
A. A health insurance plan with low premiums and high out-of-pocket costs, typically paired with a health savings account (HSA)
B. A health insurance plan with high premiums and low deductibles
C. A government-funded insurance plan with no deductibles
D. A healthcare plan that offers a fixed amount of care at no cost to the patient
Answer: A
How does “value-based care” differ from traditional fee-for-service models?
A. Providers are reimbursed based on the quantity of services they provide
B. Providers are incentivized to improve the overall quality and efficiency of care rather than the volume of services delivered
C. Providers are not reimbursed for patient care at all
D. There is no financial compensation for healthcare providers in value-based care
Answer: B
What is “cost-effectiveness analysis” in healthcare?
A. A method for determining the prices of medical services based on their cost to healthcare providers
B. A technique used to compare the costs and outcomes of different healthcare interventions to determine the best value
C. A process of eliminating expensive medical treatments from insurance coverage
D. A way of controlling healthcare costs by limiting the number of services provided
Answer: B
What role does “healthcare policy advocacy” play in shaping health reform?
A. It involves the promotion of certain healthcare reforms by lobbying legislators, policy-makers, and other stakeholders
B. It focuses on setting prices for healthcare services across the country
C. It ensures the government pays for all healthcare services
D. It eliminates insurance companies from the healthcare system
Answer: A
What is the main purpose of the “Patient Protection and Affordable Care Act” (ACA)?
A. To reduce the amount of government involvement in healthcare
B. To increase healthcare insurance premiums for individuals
C. To expand access to healthcare, reduce costs, and improve quality
D. To eliminate the use of private health insurance
Answer: C
What is the role of “accountable care organizations” (ACOs)?
A. To provide medical care exclusively to children
B. To improve the quality of care while reducing costs by coordinating healthcare services
C. To increase hospital admission rates
D. To limit the number of patients healthcare providers see
Answer: B
What is the purpose of the “Medical Loss Ratio” (MLR) rule under the ACA?
A. To ensure that insurance companies spend a certain percentage of premiums on healthcare services rather than administrative costs and profits
B. To reduce premiums for all insurance plans
C. To guarantee that insurance companies cover pre-existing conditions
D. To limit the amount of healthcare services covered by insurance
Answer: A
Which of the following describes “single-payer healthcare”?
A. Healthcare is funded by private insurance companies, and the government has no role
B. Healthcare is funded and administered by a single government entity, covering all citizens
C. Healthcare services are free for all citizens regardless of their income
D. Healthcare is divided between public and private sectors, with no universal coverage
Answer: B
Which of the following is a characteristic of “Medicare Advantage” plans?
A. They provide coverage exclusively for emergency services
B. They are offered by private insurers and provide the same benefits as Medicare Part A and Part B, with additional coverage options
C. They cover only basic inpatient care
D. They are free for all individuals who qualify for Medicare
Answer: B
Which economic concept is central to the “supply-side” theory in healthcare policy?
A. Increasing government regulation of healthcare prices
B. Reducing taxes on businesses and high-income earners to encourage investment in healthcare services
C. Expanding healthcare access by increasing public funding for health programs
D. Mandating universal health insurance coverage for all citizens
Answer: B
Which of the following best describes the concept of “healthcare cost containment”?
A. Increasing the number of healthcare providers to drive competition
B. Limiting the amount of healthcare services available to patients to reduce spending
C. Increasing government spending on public healthcare services
D. Reducing the administrative costs associated with healthcare delivery
Answer: B
How do “health insurance exchanges” under the ACA impact consumers?
A. They provide individuals with a centralized marketplace to compare and purchase insurance plans
B. They eliminate the need for individuals to pay for health insurance premiums
C. They mandate that all employers provide health insurance to employees
D. They limit the types of insurance plans available to consumers
Answer: A
Which of the following is a potential benefit of “telehealth” services?
A. Reduces the need for face-to-face consultations, potentially lowering healthcare costs
B. Increases the risk of healthcare fraud and misdiagnosis
C. Only available in rural areas
D. Decreases patient access to healthcare information
Answer: A
What is “health insurance portability” under the ACA?
A. It allows individuals to transfer health insurance coverage from one provider to another without losing benefits
B. It ensures that health insurance policies are standardized across states
C. It provides free health insurance to individuals who change jobs
D. It allows insurance providers to limit coverage based on health history
Answer: A
What does “economic burden” refer to in healthcare policy analysis?
A. The total amount the government spends on healthcare programs
B. The financial strain healthcare costs place on individuals, families, and the economy
C. The total number of healthcare professionals in the system
D. The cost of pharmaceutical drugs to healthcare providers
Answer: B
Which of the following is a primary goal of the “Public Health Service Act”?
A. To regulate the cost of prescription drugs
B. To prevent the spread of infectious diseases and improve public health
C. To provide tax incentives for private health insurance
D. To establish a national healthcare system funded by the government
Answer: B
How do “accountable care organizations” (ACOs) impact healthcare providers?
A. Providers receive financial incentives based on the quality and efficiency of the care they deliver
B. Providers are penalized if they provide care outside of a designated network
C. Providers are reimbursed based on the volume of services they deliver
D. Providers are given unlimited resources to care for patients
Answer: A
What is the main feature of a “high-deductible health plan” (HDHP)?
A. Low premiums and high deductibles, often paired with a health savings account (HSA)
B. High premiums and low deductibles
C. Comprehensive coverage with no out-of-pocket costs
D. Coverage for all types of healthcare, including dental and vision
Answer: A
What is the purpose of the “State Children’s Health Insurance Program” (SCHIP)?
A. To provide healthcare coverage for children in low-income families who do not qualify for Medicaid
B. To provide medical insurance for college students
C. To provide adult health insurance for those who cannot afford premiums
D. To offer government-funded long-term care for children
Answer: A
Which of the following is a “demand-side” strategy to reduce healthcare costs?
A. Limiting the number of healthcare providers in the market
B. Encouraging consumers to compare health plans and select cost-effective options
C. Reducing the number of services covered by insurance plans
D. Imposing price controls on healthcare providers
Answer: B
How do “Medicaid” and “Medicare” differ in terms of eligibility?
A. Medicaid covers low-income individuals and families, while Medicare covers individuals over 65 and certain disabilities
B. Medicaid only covers children, while Medicare covers all adults
C. Medicaid provides coverage for those with private insurance, while Medicare only covers government employees
D. There is no difference in eligibility between Medicaid and Medicare
Answer: A
Which of the following is an example of “managed care”?
A. Patients are free to choose any healthcare provider without restrictions
B. Insurance plans limit patient choice of providers and emphasize cost-efficiency
C. Patients are reimbursed based on the number of services provided
D. Providers are paid based on the number of patients they see
Answer: B
What is “universal health coverage”?
A. A healthcare system where every citizen is required to purchase private insurance
B. A system in which every citizen has access to the health services they need without financial hardship
C. A program that provides insurance coverage only for children and elderly citizens
D. A government program that limits healthcare services to a specific region
Answer: B
What is the primary goal of “cost-effectiveness analysis” in healthcare policy?
A. To determine the total cost of healthcare delivery in a country
B. To compare the relative costs and health outcomes of different healthcare interventions
C. To reduce the amount of money spent on healthcare providers
D. To ensure that all healthcare services are provided for free
Answer: B
What is a “patient-centered medical home” (PCMH)?
A. A healthcare model where primary care providers manage all aspects of a patient’s care, emphasizing prevention and coordinated care
B. A healthcare model focusing only on emergency medical services
C. A home where patients are given full medical treatments regardless of cost
D. A system where patients can only visit specialists without seeing a primary care physician
Answer: A
What does “healthcare interoperability” refer to?
A. The ability of different healthcare systems to work together, sharing patient data securely
B. The uniform pricing of all medical services across healthcare providers
C. The integration of alternative medicine into mainstream healthcare
D. The restriction of healthcare services to a single network
Answer: A
How does “preventive care” impact healthcare costs?
A. It typically leads to higher short-term costs but reduces long-term healthcare spending by preventing more serious health conditions
B. It reduces overall healthcare spending by eliminating the need for emergency care
C. It has no impact on overall healthcare spending
D. It increases healthcare costs by encouraging unnecessary testing
Answer: A
What is “bundled payment” in healthcare reimbursement?
A. Providers are paid a single payment for all services related to a treatment or condition, rather than separate payments for each service
B. Providers are reimbursed for every single service provided, regardless of treatment effectiveness
C. Providers are paid a flat fee for every patient treated, regardless of condition
D. Patients are required to pay a single out-of-pocket fee for all services they receive
Answer: A
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