Question 1

Discuss why employer sponsored health insurance contracts rarely include coverage of substance abuse, mental health, HIV/AIDS and similar treatments.

Accepted Answer

Offering such generous benefits is likel

Question 2

Small group coverage mitigates the problem of adverse selection for the nine percent of the population who purchase health insurance individually.

Accepted Answer

A) True 
 B)False

Question 3

More than half of the U.S. population is covered by employer group health insurance. One of the underlying reasons is that

Accepted Answer

A)  covering a large group under a single contract increases transaction costs. 
B)  group coverage increases adverse selection. 
C)  employer payments towards health insurance premiums reduce tax benefits. 
D)  many of the most expensive patients are heavily subsidized or excluded. 
E)  it is both the most preferred and the most common method for part-time employees to obtain affordable coverage. 
A)  covering a large group under a single contract increases transaction costs. 
B)  group coverage increases adverse selection. 
C)  employer payments towards health insurance premiums reduce tax benefits. 
D)  many of the most expensive patients are heavily subsidized or excluded. 
E)  it is both the most preferred and the most common method for part-time employees to obtain affordable coverage.

Question 4

The preferred provider organizations (PPOs) are the most comprehensive type of managed care organizations, providing all care, including building their own hospitals, hiring their own doctors and implementing sophisticated electronic record keeping systems. Kaiser Permanente is an example.

Accepted Answer

A) True 
 B)False

Question 5

An important feature of health insurance companies' pricing policies is that in the long run, cyclical trends of overcharging and undercharging can be observed, with each cycle period lasting 1-3 years.

Accepted Answer

A) True 
 B)False

Question 6

Health Savings Accounts may contribute to risk sharing problem as younger, healthier, better educated individuals tend to use the HSAs as savings accounts.

Accepted Answer

A) True 
 B)False

Question 7

Medicare provides government insurance to the poor, while Medicaid provides government insurance for the elderly.

Accepted Answer

A) True 
 B)False

Question 8

You give birth to healthy twins. After two days in hospital, case control nurse reviews your records to determine if it is medically necessary for you to remain another day in hospital. This is an example of

Accepted Answer

A)  pre-admission testing. 
B)  concurrent review. 
C)  retrospective review. 
D)  discharge planning. 
E)  database profiling. 
A)  pre-admission testing. 
B)  concurrent review. 
C)  retrospective review. 
D)  discharge planning. 
E)  database profiling.

Question 9

An actuarial assistant at your HMO presents graphs and charts of the number of colonoscopies performed per 1,000 patients by each doctor in the plan. This is an example of

Accepted Answer

A)  pre-admission testing. 
B)  concurrent review. 
C)  retrospective review. 
D)  discharge planning. 
E)  database profiling. 
A)  pre-admission testing. 
B)  concurrent review. 
C)  retrospective review. 
D)  discharge planning. 
E)  database profiling.

Discuss why employer sponsored health insurance contracts rarely include coverage of substance abuse, mental health, HIV/AIDS and similar treatments.

Small group coverage mitigates the problem of adverse selection for the nine percent of the population who purchase health insurance individually.

More than half of the U.S. population is covered by employer group health insurance. One of the underlying reasons is that

The preferred provider organizations (PPOs) are the most comprehensive type of managed care organizations, providing all care, including building their own hospitals, hiring their own doctors and implementing sophisticated electronic record keeping systems. Kaiser Permanente is an example.

An important feature of health insurance companies' pricing policies is that in the long run, cyclical trends of overcharging and undercharging can be observed, with each cycle period lasting 1-3 years.

Health Savings Accounts may contribute to risk sharing problem as younger, healthier, better educated individuals tend to use the HSAs as savings accounts.

Medicare provides government insurance to the poor, while Medicaid provides government insurance for the elderly.

You give birth to healthy twins. After two days in hospital, case control nurse reviews your records to determine if it is medically necessary for you to remain another day in hospital. This is an example of

An actuarial assistant at your HMO presents graphs and charts of the number of colonoscopies performed per 1,000 patients by each doctor in the plan. This is an example of

Choices: Money, Medicine, and Health

Demand and Supply

Cost-Benefit and Cost-Effectiveness Analysis

Health Insurance: Financing Medical Care

Physicians

Medical Education, Organization, and Business Practices

Hospitals

Management and Regulations of Hospital Costs

Long-Term Care

Pharmaceuticals

Financing and Ownership of Health Care Providers

Macroeconomics and Medical Care

The Role of Government and Public Goods

History, Demography, and the Growth of Modern Medicine

International Comparisons of Health and Health Expenditures

Economic Evaluation of Health Policy: The Patient Protection and Affordable Care Act of 2010

Value for Money in the Future of Health Care

Filters

Exam 5: Insurance Contracts and Managed Care

Discuss why employer sponsored health insurance contracts rarely include coverage of substance abuse, mental health, HIV/AIDS and similar treatments.

Small group coverage mitigates the problem of adverse selection for the nine percent of the population who purchase health insurance individually.

More than half of the U.S. population is covered by employer group health insurance. One of the underlying reasons is that

The preferred provider organizations (PPOs) are the most comprehensive type of managed care organizations, providing all care, including building their own hospitals, hiring their own doctors and implementing sophisticated electronic record keeping systems. Kaiser Permanente is an example.

An important feature of health insurance companies' pricing policies is that in the long run, cyclical trends of overcharging and undercharging can be observed, with each cycle period lasting 1-3 years.

Health Savings Accounts may contribute to risk sharing problem as younger, healthier, better educated individuals tend to use the HSAs as savings accounts.

Medicare provides government insurance to the poor, while Medicaid provides government insurance for the elderly.

You give birth to healthy twins. After two days in hospital, case control nurse reviews your records to determine if it is medically necessary for you to remain another day in hospital. This is an example of

An actuarial assistant at your HMO presents graphs and charts of the number of colonoscopies performed per 1,000 patients by each doctor in the plan. This is an example of

Choices: Money, Medicine, and Health

Demand and Supply

Cost-Benefit and Cost-Effectiveness Analysis

Health Insurance: Financing Medical Care

Physicians

Medical Education, Organization, and Business Practices

Hospitals

Management and Regulations of Hospital Costs

Long-Term Care

Pharmaceuticals

Financing and Ownership of Health Care Providers

Macroeconomics and Medical Care

The Role of Government and Public Goods

History, Demography, and the Growth of Modern Medicine

International Comparisons of Health and Health Expenditures

Economic Evaluation of Health Policy: The Patient Protection and Affordable Care Act of 2010

Value for Money in the Future of Health Care

Filters