Question 1

Kaiser-Permanente, the nations 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. B

Question 2

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 3

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. E

Question 4

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 5

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 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

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 8

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

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 9

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 10

Some analysts are skeptical about managed care's long-term ability to control costs.What works for individuals may not work systemwide.This proposition is called

Accepted Answer

A) stare decisis. 
B) a priori reasoning. 
C) the Peter Principle. 
D) the ceteris paribus condition. 
E) the fallacy of composition. 
A) stare decisis. 
B) a priori reasoning. 
C) the Peter Principle. 
D) the ceteris paribus condition. 
E) the fallacy of composition.

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

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.

Question 13

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.

Kaiser-Permanente, the nations largest health maintenance organization, was founded

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

Capitation

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

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

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

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

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

Some analysts are skeptical about managed care's long-term ability to control costs.What works for individuals may not work systemwide.This proposition is called

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

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

Usmedical Care: A System in Transition

Using E Conomics to Study Health Care Issues

Analyzing Medical Care Markets

Economic Evaluation in Health Care

The De Mand for Health and Medical Care

The Market for Health Insurance

The Physicians Servic ES Market

The Hospital Services Market

The Market for Pharmaceuticals

Confounding Factors

Policies That Enha Nce Access

Policies to Contain Costs

Medical Care Systems Worldwide

Filters

Exam 7: Managed Care

Kaiser-Permanente, the nations largest health maintenance organization, was founded

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

Capitation

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

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

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

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

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

Some analysts are skeptical about managed care's long-term ability to control costs.What works for individuals may not work systemwide.This proposition is called

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

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

Usmedical Care: A System in Transition

Using E Conomics to Study Health Care Issues

Analyzing Medical Care Markets

Economic Evaluation in Health Care

The De Mand for Health and Medical Care

The Market for Health Insurance

The Physicians Servic ES Market

The Hospital Services Market

The Market for Pharmaceuticals

Confounding Factors

Policies That Enha Nce Access

Policies to Contain Costs

Medical Care Systems Worldwide

Filters