HE380 Managed Healthcare Exam 1 Answers (Ashworth College) - 2020

 HE380 Managed Healthcare Exam 1 Answers (Ashworth College) - 2020

 

 

 

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1. This act was signed into law on March 23, 2010 in an attempt to improve the existing healthcare conditions and is recognized as one of the most sweeping healthcare legislation passed in the US since 1965, when Medicare and Medicaid were enacted.

2. This new product emerged during the mid 1980s, where members have HMO-like coverage with little cost sharing if they both used the HMO network and accessed care through their PCP.

3. All of the following are provisions of the ACA EXCEPT:

4. Which of the following is NOT an example of change that has occurred within the US healthcare system in recent years?

5. What act created in 1942, imposed wage and price controls on businesses, including limiting their ability to pay higher wages to attract scarce workers?

6. This system severed the financial link between the provider of service and the patient, and this disconnect has fostered increases in both the price of services and their utilization.

7. In considering the history of health plans, the following events took place, making this year to be considered a remarkable year in the history of health plans: Michael Shadid, MD established rural farmers' cooperative health plan, and Dr. Ross and Dr. Loos established a comprehensive prepaid medical plan for workers in Los Angeles Department of Water and Power. In what year did these two events take place?

8. The basic __________ structure was created in 1954 to compete with Kaiser when the San Joaquin County Medical Society formed the San Joaquin Medical Foundation.

9. In what year did Congress establish two landmark entitlement programs: Medicare for the elderly and Medicaid for selected low-income populations?

10. Factors that led to increasing costs of healthcare include all of the following EXCEPT:

11. The origins of Blue Cross (BC) began in 1929 when what hospital agreed to provide some 1500 teachers with prepaid inpatient care at its hospital?

12. These specific types of plans operated independently from the beginning from each other and are collectively referred to as the:

13. During the 1990s which of the following trends occurred?

14. During the 1990s what type of shift occurred with utilization management?

15. Which of the following is NOT an important feature of the HMO Act?

16. In 1937, what organization was started in Washington, D.C., at the behest of the Home Owners' Loan Corporation to reduce the number of mortgage defaults that resulted from large medical expenses?

17. What concept is said to have diminished competition to the point of bringing into question the viability of the competitive model in the delivery of healthcare services?

18. Precertification for elective hospitalizations means that:

19. What were the two models of providing and paying for health care, besides the patient paying for services rendered, called?

20. In what decade did a handful of large corporations initiate precertification and concurrent review for inpatient care, to the dismay of the provider community?