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URPN Quiz 3

Terms in this set (24)

As of 2016, the Affordable Care Act eliminated the "Donut Hole" in Medicare Part D through deep discounts and generic drugs.
False
Which approach to controlling health care costs are most Americans uncomfortable with, although it is commonly used in other nations?
Rationing health care services
Which of the following is NOT true about the Over the Counter (OTC) market:
The OTC market is a $374 billion market.
The following countries are examples of National health insurance (single-payer) systems:
Canada, Norway, and Sweeden
The following may be issues when implementing a P4P system based on outcomes, because it may lead to "cherry picking" of patients.
-Individual behavior of patient
-Patient mix
Innovations in the UK health system to increase quality outcomes include:
-Hospitals compete for national dollars
-GPs can receive incentive payments based on performance
Medicare is comparable to a system like Canada, where the providers are not directly employed by the government but paid through a government single payer.
True
One measurement of PROCESS quality is patent satisfaction, which can be measured using surveys.
False
Which driver of health care enables consumers to comparison shop for health care?
Public reporting
Pharmacy bills get expensive quickly, even for healthy, insured patients in the United States. What are some reasons that can explain this cost?
-Americans pay more for pharmaceuticals than individuals in other countries
-Americans have the highest usage of pharmaceuticals
-Patent protections ensure a monopoly on new drugs
What are some of the ways that Japan keeps its health care costs down?
Every two years the Ministry of Health negotiates with physicians to set the price for every procedure.
Insurance companies in the United States typically accept the price set by drug companies, especially when there is no competition in the therapeutic area. How do insurance companies try to ofset the cost of pharmaceuticals (select all that apply):
-Requiring prior authorization of a drug
-Through the use of formularies, placing emphasis on covering generic drugs in Tier 1
-Increasing enrollee cost-sharing amounts through higher co-pays
Most countries with national health insurance systems finance these systems with which of the following?
Payroll taxes
Americans receive recommended (Best Practices) care _____% of the time.
55%
The Federal agency that is tasked with enhancing quality, appropriateness, and effectiveness of health care services and access to care by conducting and supporting research, demonstration projects, and evaluations; developing guidelines; and disseminating information on health care services and delivery systems is:
Agency from Healthcare Research & Quality
Which health care system model is characterized by a dominant share of financing derived from general revenue taxes?
Beveridge model
The following is true of the "sickness funds" in Germany.
-Sickness funds are nonprofit and cannot deny coverage based on preexisting conditions
-Sickness funds can require range of cost sharing depending on their plan
-They compete with each other for members, and fund managers are paid based on the size of their enrollments
We can incentivize quality care through which of the following measures (check all that apply):
-Regulation
-Professionalism
-Public Reporting
-Payment
The best patient outcomes, relative to the amount of money we as individuals or as a society, are able and/or willing to pay to stay healthy or recover from illness, is:
Value
When compared with other OECD nations in terms of health care, the U.S. may be characterized as having which of the following?
High expenses with large inequities in access to primary and specialty care
In the United Kingdom, most general practitioners and dentists receive payment in which of the following ways?
Combination of capitation and fee-for-service
Which of the following are examples of health care expenditures that lack value (mark all that apply):
-Defensive medicine
-Waste
-Overconsumption
There is a financial misalignment between what providers are paid, and the number of services they provide. Pay for Performance (P4P) is an attempt to bring about quality by shifting the focus toward all but which of the following:
increasing focus on patient volume
Among health care programs in the U.S., which is the best example of socialized medicine?
Veterans hospital administration
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