Exam 14: Finance Health Care
Health insurance benefits paid by the employer are exempt from personal income taxes and social security taxes of the employee.
True
Assuming that the price of a medical encounter is $1,000 and the beneficiary has an unmet $500 deductible and 20% coinsurance rate, the amount the beneficiary will pay is:
C
What are bundled payment and how are they being used in health care?
Bundled payments are a payment method based on the costs expected to be incurred in the provision of a clinically defined episode of care, adjusted for severity and complexity of a patient's condition. Bundled payments are viewed as a blend of fee-for-service and capitation payments, discouraging the provision of unnecessary care and encouraging the coordination of care across providers, but not penalizing providers who care for sicker patients in their practice. The goal of bundled payment is to reduce fragmentation of care thereby improving quality and reducing costs. The use of bundled payments should encourage providers within the system to reorganize how care is delivered so that it is coordinated and responsive to the needs of patients.
To be effective a consumer-engagement strategy must help consumers to
The focus of concern regarding rising healthcare costs should be on the absolute size of spending in the health care sector.
If there is a vertical supply curve, then a mandated benefit will result in a full employment effect.
A stop-loss feature sets a lower limit on the amount the consumer will have to pay during a specified period of time (e.g., annually or a lifetime).
A tax that has a larger relative impact on the incomes of high-income individuals than on low-income individuals is considered to be
What will be the effect of mandated health insurance benefits on the market for labor if the workers do not place any value on these benefits? If they fully value the benefits?
The fixed amount that must be paid before insurance pays anything on the medical service is the
Under the community rating method, all enrollees in a plan are charged the same premium.
How do each of the following methods of financing the healthcare system impact on persons according to their income group?
A. Income tax
B. Sales tax
C. Payroll tax
D. Insurance premiums
The higher the deductible, the fewer the claims that will need to be processed.
The burden of a sales tax will be shared by consumer and supplier.
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