Question 1

The health maintenance organization where the physicians are salaried employees of the HMO is called

Accepted Answer

A)  a group-model HMO. 
B)  a staff-model HMO. 
C)  a network-model HMO. 
D)  an IPA. 
E)  a direct-contract HMO. 
A)  a group-model HMO. 
B)  a staff-model HMO. 
C)  a network-model HMO. 
D)  an IPA. 
E)  a direct-contract HMO. B

Question 2

Most empirical studies show that the cost-savings provided by managed care are accomplished by

Accepted Answer

A)  better preventive care. 
B)  reducing the rate of hospitalization. 
C)  denying access to costly specialty care. 
D)  switching to generic drugs. 
E)  all of the above. 
A)  better preventive care. 
B)  reducing the rate of hospitalization. 
C)  denying access to costly specialty care. 
D)  switching to generic drugs. 
E)  all of the above. B

Question 3

The most important aspect of the change from fee-for-service to capitation is that

Accepted Answer

A)  physicians get their money quicker. 
B)  patients get faster service since physicians don't have to worry about getting paid. 
C)  physicians make less money. 
D)  the most valuable patient is no longer the sickest, but the most healthy. 
A)  physicians get their money quicker. 
B)  patients get faster service since physicians don't have to worry about getting paid. 
C)  physicians make less money. 
D)  the most valuable patient is no longer the sickest, but the most healthy. D

Question 4

To control moral hazard and the increased spending that accompanies it, managed care providers include _______ in contracts with providers.

Accepted Answer

A)  clinical rules 
B)  capitation 
C)  risk sharing 
D)  all of the above 
A)  clinical rules 
B)  capitation 
C)  risk sharing 
D)  all of the above

Question 5

What is the motivation behind the cost-control features of managed care?

Accepted Answer

A)  To ensure access to specialty care through general practitioner gatekeepers. 
B)  To influence the way physicians practice medicine by changing the financial incentive structure of medical care delivery. 
C)  to shift the financial risk onto patients. 
D)  to eliminate all the guesswork from diagnoses by establishing practice guidelines. 
E)  to create competition by providing patients with a wide range of providers. 
A)  To ensure access to specialty care through general practitioner gatekeepers. 
B)  To influence the way physicians practice medicine by changing the financial incentive structure of medical care delivery. 
C)  to shift the financial risk onto patients. 
D)  to eliminate all the guesswork from diagnoses by establishing practice guidelines. 
E)  to create competition by providing patients with a wide range of providers.

Question 6

The health maintenance organization that contracts with individual physicians or group practices to provide care for a specified group of enrollees is called

Accepted Answer

A)  a group-model HMO. 
B)  a staff-model HMO. 
C)  a network-model HMO. 
D)  an IPA. 
E)  a direct-contract HMO. 
A)  a group-model HMO. 
B)  a staff-model HMO. 
C)  a network-model HMO. 
D)  an IPA. 
E)  a direct-contract HMO.

Question 7

Network model HMOs use _______ to shift financial risk back onto providers.

Accepted Answer

A)  capitation. 
B)  practice guidelines. 
C)  open panels. 
D)  closed panels. 
E)  formularies. 
A)  capitation. 
B)  practice guidelines. 
C)  open panels. 
D)  closed panels. 
E)  formularies.

Question 8

Managed care

Accepted Answer

A)  establishes a system of retrospective payment determined ex ante. 
B)  combines the responsibilities of payer and provider of medical services. 
C)  attempts to shift a portion of the financial risk onto providers. 
D)  attempts to shift a portion of the financial risk onto patients. 
E)  Both b and c are correct. 
A)  establishes a system of retrospective payment determined ex ante. 
B)  combines the responsibilities of payer and provider of medical services. 
C)  attempts to shift a portion of the financial risk onto providers. 
D)  attempts to shift a portion of the financial risk onto patients. 
E)  Both b and c are correct.

Question 9

Kaiser-Permanente, the nation's largest health maintenance organization, was founded

Accepted Answer

A)  to provide cost-effective medical care to Kaiser employees. 
B)  to provide access to medical care to Kaiser workers in remote locations where medical services were in short supply. 
C)  to slow the rate of growth in medical spending for Kaiser employees. 
D)  as a group-model HMO. 
E)  as a network-model HMO. 
A)  to provide cost-effective medical care to Kaiser employees. 
B)  to provide access to medical care to Kaiser workers in remote locations where medical services were in short supply. 
C)  to slow the rate of growth in medical spending for Kaiser employees. 
D)  as a group-model HMO. 
E)  as a network-model HMO.

Question 10

The RAND Health Insurance experiment compared costs of HMOs with the costs of indemnity insurers. The study

Accepted Answer

A)  confirmed the cost-saving potential of HMOs. 
B)  Found no cost-saving by HMOs. 
C)  the HMO had per capita costs that were 28% lower than the indemnity 
D)  both a and c 
A)  confirmed the cost-saving potential of HMOs. 
B)  Found no cost-saving by HMOs. 
C)  the HMO had per capita costs that were 28% lower than the indemnity 
D)  both a and c

Question 11

Which of the following statements is not true about managed care?

Accepted Answer

A)  Empirical evidence suggests that managed care can reduce health care spending. 
B)  Most of managed care's savings can be traced to reduced hospitalization. 
C)  There is more emphasis on preventive care in managed care. 
D)  There is no credible evidence to suggest lower quality of care for any group of patients in managed care arrangements. 
A)  Empirical evidence suggests that managed care can reduce health care spending. 
B)  Most of managed care's savings can be traced to reduced hospitalization. 
C)  There is more emphasis on preventive care in managed care. 
D)  There is no credible evidence to suggest lower quality of care for any group of patients in managed care arrangements.

Question 12

Which type of managed care organization has the strictest cost control features?

Accepted Answer

A)  Group-model HMO. 
B)  IPA. 
C)  POS plan. 
D)  Closed-panel HMO. 
E)  PPO. 
A)  Group-model HMO. 
B)  IPA. 
C)  POS plan. 
D)  Closed-panel HMO. 
E)  PPO.

Question 13

Capitation

Accepted Answer

A)  creates pressures to provide fewer services. 
B)  is a fixed payment determined in advance to pay for all medically-necessary care. 
C)  is the maximum allowable fee in a fee-for-service system. 
D)  shifts financial risk onto patients. 
E)  Both a and b are correct. 
A)  creates pressures to provide fewer services. 
B)  is a fixed payment determined in advance to pay for all medically-necessary care. 
C)  is the maximum allowable fee in a fee-for-service system. 
D)  shifts financial risk onto patients. 
E)  Both a and b are correct.

The health maintenance organization where the physicians are salaried employees of the HMO is called

Most empirical studies show that the cost-savings provided by managed care are accomplished by

The most important aspect of the change from fee-for-service to capitation is that

To control moral hazard and the increased spending that accompanies it, managed care providers include _______ in contracts with providers.

What is the motivation behind the cost-control features of managed care?

The health maintenance organization that contracts with individual physicians or group practices to provide care for a specified group of enrollees is called

Network model HMOs use _______ to shift financial risk back onto providers.

Managed care

Kaiser-Permanente, the nation's largest health maintenance organization, was founded

The RAND Health Insurance experiment compared costs of HMOs with the costs of indemnity insurers. The study

Which of the following statements is not true about managed care?

Which type of managed care organization has the strictest cost control features?

Capitation

US Medical Care: an Uncertain Future

Using Economics to Study Health Care Issues

Analyzing Medical Care Markets

Economic Evaluation in Health Care

The Demand for Health and Medical Care

Population Health

The Market for Health Insurance

The Physicians Services Market

The Hospital Services Market

The Market for Pharmaceuticals

Medicare

Medicaid

Medical Care Systems Worldwide

Filters

Exam 8: Managed Care

The health maintenance organization where the physicians are salaried employees of the HMO is called

Most empirical studies show that the cost-savings provided by managed care are accomplished by

The most important aspect of the change from fee-for-service to capitation is that

To control moral hazard and the increased spending that accompanies it, managed care providers include _______ in contracts with providers.

What is the motivation behind the cost-control features of managed care?

The health maintenance organization that contracts with individual physicians or group practices to provide care for a specified group of enrollees is called

Network model HMOs use _______ to shift financial risk back onto providers.

Managed care

Kaiser-Permanente, the nation's largest health maintenance organization, was founded

The RAND Health Insurance experiment compared costs of HMOs with the costs of indemnity insurers. The study

Which of the following statements is not true about managed care?

Which type of managed care organization has the strictest cost control features?

Capitation

US Medical Care: an Uncertain Future

Using Economics to Study Health Care Issues

Analyzing Medical Care Markets

Economic Evaluation in Health Care

The Demand for Health and Medical Care

Population Health

The Market for Health Insurance

The Physicians Services Market

The Hospital Services Market

The Market for Pharmaceuticals

Medicare

Medicaid

Medical Care Systems Worldwide

Filters