HC Systems Practice Midterm

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Which of the following news network / bias pairing is correct?

A) Wall Street Journal - Left
B) New York Post - Left
C) Politico - Right
D) Boston Herald - Right
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Terms in this set (30)
Which of the following news network / bias pairing is correct?

A) Wall Street Journal - Left
B) New York Post - Left
C) Politico - Right
D) Boston Herald - Right
D) Boston Herald - Right
What is the biggest reason why people immigrate to the United States?

A) Humanitarian (refugees)
B) Work
C) Reunification of families
D) Free movements
C) Reunification of families
The US is considered to be a very individualistic country. Which country is NOT considered individualistic?

A) China
B) New Zealand
C) UK
D) Australia
A) China
What is CORRECT regarding the 80/20 rule?

A) It is also known as the Medical Loss Ratio.
B) It requires insurance companies to spend at least 80% of the money they take in from premiums on health care costs and quality improvement activities.
C) The other 20% can go to profits, administrative, overhead, and marketing costs.
D) All of the above
D) All of the above
"A candidate must have the emotional health to fully use their intellectual ability, exercise good judgement, and to complete all responsibilities attendant to the evaluation and treatment of patients." Which of the five key elements of the Duke technical standards does this skill best represent?

A) Communication
B) Motor and Sensory Function
C) Intellectual-Conceptual, Integrative, and Quantitative Abilities
D) Behavioral and Social Skills
D) Behavioral and Social Skills
T or F: Insurance companies made a lot of money during COVID.
True

Avg. gross margins per member per month in 2020 - $156

Avg. First Quarter Individual Market Monthly Premiums and Claims Per Person - $523 premiums and $366 claims
T or F: If the Bismarck model were implemented in the US, the costs would go up for employees.
False

Goes up for employers
Which of the following is INCORRECT regarding Modifier 59?

A) Modifier 59 is used to identify procedures and/or services that are not normally together, but are appropriate under the circumstances.
B) When billing manual therapy and therapeutic activities, each 59 is only appropriate if the therapist performs the two procedures in distinctly different 15-minute intervals.
C) In some circumstances, you can report the two codes together if you performed them during the same 15-minute time interval.
D) All of the above are correct
C) In some circumstances, you can report the two codes together if you performed them during the same 15-minute time interval.

False - you cannot (which is why choice B is correct)
Which description best characterizes the Pew Research Institute?

A) Right leaning and accurate
B) Left leaning and accurate
C) Bipartisan and accurate
D) Bipartisan and inaccurate
C) Bipartisan and accurate
Which of the following is NOT a parameter suggested by the World Health Organization for a single payer model to work?

A) Government should allot sufficient funds to fully cover every constituent
B) Equity in access to health services
C) Quality of health services should improve health
D) People should be protected against financial risk
A) Government should allot sufficient funds to fully cover every constituent
Which occupation is NOT included in the list of America's fastest growing occupations? A) Physical therapists B) Physical therapist aides C) Medical doctors D) Wind turbine service techniciansC) Medical doctorsWhich example of failed policy in the US was due to operations (as opposed to oversight)? A) 9/11 B) Hurricane Katrina C) Financial collapse of 2008 D) BP oil spillB) Hurricane Katrina Others were due to oversightFill in the blanks: Chronic diseases (e.g. diabetes and heart disease) make up __________% of health care costs. Sickest ____________% of the population consumes 50% of total health care costs. A) 85, 5 B) 85, 10 C) 75, 5 D) 75, 10A) 85, 5What percentage do the healthiest 50% make up for total healthcare spending in the US? A) 1% B) 3% C) 5% D) 8%B) 3%Which statement is INCORRECT regarding coding? A) One-on-one codes can only be billed for services with manual contact. B) Supervised modalities do not require direct patient contact. C) Time-based codes require direct one-on-one contact with patients and can be billed multiple times. D) Service based codes are untimed and can bill only one time per session, regardless of how many body parts are involved.A) One-on-one codes can only be billed for services with manual contact. Visual, verbal and/or manual contact during the time of serviceYou are treating a Medicare patient and their treatment units summate to 40 minutes. How many units of 15 minute codes can you bill? A) 1 unit B) 2 units C) 3 units D) 4 unitsC) 3 unitsWhich of the following is NOT a con of universal healthcare? A) It forces healthy people to pay for others' medical care. B) Without financial incentive, people may not be as careful with their health. C) Most universal health systems report long wait times for elective procedures. D) Hospitals and doctors may begin administering inconsistent care.D) Hospitals and doctors may begin administering inconsistent care.Which of the following is INCORRECT regarding the history of Medicare and Medicaid? A) John F. Kennedy made an unsuccessful push for a national health care program for seniors. B) Medicare went into effect immediately after legislation was signed in 1965. C) Medicaid was established as an entitlement and was enacted in 1965 as companion legislation to Medicare. D) Medicaid provided federal matching grants to states to finance care.B) Medicare went into effect immediately after legislation was signed in 1965. Signed into law in 1965 but began being implemented in 1966.T or F: US has the highest rate of deaths amenable to health care among comparable countries.TrueHow many people are covered by Medicaid? A) 13 million people B) 55 million people C) 83 million people D) 95 million peopleC) 83 million peopleWhat population was Medicaid NOT originally intended for? A) Single parents with dependent children B) Aged population C) Young, working class adults D) Disabled populationC) Young, working class adultsWho is NOT covered by Medicare? A) 65 and older B) Under 65 with certain disabilities C) Any age with end-stage renal disease D) Welfare populationD) Welfare population Intended for MedicaidWhat population makes the majority of Medicaid enrollees? A) Children B) Adults C) Elderly D) DisabledA) Children Children are 48%. However, disabled population makes up majority of expenditures (42%).T or F: For bundled payments, payment rates are negotiable and fluctuate for any given common, expensive condition depending on the patient's co-morbidities.False Pre-determined payment rates for common, expensive conditions, in which the provider takes full responsibility for how payments are madeWhich statement is CORRECT regarding US taxation? A) The US pays more in taxes (by percentage) than most countries. B) The US has higher taxation for income and property than most countries. C) The US pays the same in social security taxes when compared to most countries. D) Both A and BB) The US has higher taxation for income and property than most countries.Your patient has a Medicare plan which has hospital, medical, and prescription drug coverage all in one package. What plan does this most resemble? A) Part A B) Part B C) Part C D) Part DC) Part CWho are key players that drive public policy changes? A) Patients B) Third party payers C) The economy D) All of the aboveD) All of the aboveYou're analyzing a country's healthcare model. You observe that this country's healthcare model controls costs by limiting the medical services they will pay for, or by making patients wait to be treated. The hospitals are private but bills are paid by the government and are funded by taxes. What model does this most resemble? A) Beveridge Model B) Bismarck Model C) NHI Model D) Out-of-Pocket ModelC) NHI ModelWho oversees CPT codes and ICD10 codes? A) WHO oversees CPT codes and AMA oversees ICD10 codes. B) AMA oversees CPT codes and WHO oversees ICD10 codes. C) WHO oversees both CPT and ICD10 codes. D) AMA oversees both CPT and ICD10 codes.B) AMA oversees CPT codes and WHO oversees ICD10 codes.A given country falls below the Lorenz curve. What does this mean? A) They have a small GINI coefficient, indicating more sharing of wealth. B) They have a small GINI coefficient, indicating less sharing of wealth. C) They have a large GINI coefficient, indicating more sharing of wealth. D) They have a large GINI coefficient, indicating less sharing of wealth.D) They have a large GINI coefficient, indicating less sharing of wealth.