Exam 9: Health Care Systems and Policy

Medicare was amended in 2000 to cover nutrition therapy as an outpatient benefit under Part B of the Medicare program.

What is a consumer-directed health plan? What are its benefits and limitations?

In the United States, there are two general categories of health insurance: private insurance and managed care plans.

What best describes how a PPO differs from an HMO?

List three of the major provisions of the Affordable Care Act of 2010.

​Match the HMO model with its correct description. Options will only be used once. -​HMO owns and operates its own facility, is equipped for laboratory, pharmacy, and X-ray services, and hires its own physicians and other health care providers.

​Match the definition in the left column with its correct term in the right column. Options will only be used once. -​Approach to paying for health care in which insurers try to limit the use of health services, reduce costs, or both

The cost effectiveness of nutrition services is uncertain.

An advantage of the traditional fee-for-service insurance is that it encourages physicians to provide more services than may be necessary.

Discuss three cost containment efforts.

A health insurance contract that is made with an employer or other entity and covers several people by reference to their relationship to the entity is known as a ____.

Differentiate between traditional systems of health care and managed forms of health care.

Which type of health insurance is available as either traditional plans or group contract insurance?

An individual who is ____ would be eligible for Medicare benefits.

​Match the definition in the left column with its correct term in the right column. Options will only be used once. -​Portion of the charge for medical services that the patient must pay

​Match the definition in the left column with its correct term in the right column. Options will only be used once. -​A cost-sharing requirement in which the insured assumes a portion of the costs of covered expenses

Summarize the demographic characteristics of those without health insurance.

​Match the definition in the left column with its correct term in the right column. Options will only be used once. -​A predetermined fee paid per enrollee per month to the participating health care provider

A self-insured health plan describes a plan where the risk for medical costs is assumed by the patient, rather than an insurance company.

List six activities that promote health reform and that are included within the scope of dietetics practice.