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15 Cards in this Set

  • Front
  • Back
A method of reimbursing providers (usually physicians) with a fixed payment typically expressed as a per-member-per-month payment that is made in advance for future anticipated contracted health services is called?

a) social security

b) capitation

c) federal health care financing

d) retrospective payment system
capitation
The Federal Government agency that administers Medicare & Medicaid. Formally known as the Health Care Financing Administration (HCFA)is?

a)Public Health Administartion

b)State Insurance Fund

c) Centers for Medicare & Medicaid Services

d) National Health Care Systems
Centers for Medicare & Medicaid Services
A term used referring to reimbursement based on a pre-determined fixed price per case or diagnosis for clients in 468 categories is called?

a) NDX

b) Diagnosis-related groups

c) retrospective payment groups

d) social security grant and funding services
Diagnosis-related groups (DRGs)
The total output of all goods and services in the country is called?

a) gross domestic product

b) national gross product

c) capitation

d) comprehensive national consumption
gross domestic product (GDP)
A change in some variable is called?

a) variance

b) variable margin

c) marginal

d) marginal variance
marginal
A jointly sponsored state and federal program that pays for medical services for the elderly, poor, blind, disabled, and for families with dependent children

a) Medicaid

b) Centers for Medicare & Medicaid Services

c) Federal Public Welfare

d) Medicare
Medicaid
A federally funded health insursnce program for the disabled, persons with end stage renal disease and persons 65 years of age and older who qualify for social security benifits?

a) Health Care Financing Administration

b) Medicare

c) Social Security

d) Medicaid
Medicare
A method of reimbursing health care providers an amount for which is predetermined based on the patients diagnosis is called?

a) medicaid

b) medicare

c) social security funding

d) prospective payment system
prospective payment system
A method of reimbursing health care providers for which services are rendered and charges are billed based on the services provided?

a) medicaid

b) medicare

c) retrospective payment system

d) prospective payment system
retrospective payment system
An organization other than the patient and the supplier that assumes responsibility for the payment of charges is called?

a) medicare

b) medicaid

c) charity

d) third party
third party
Two factors that contributed to the lack of cost consciousness in health care are?

a) increased disease; increased population

b) medical research;expanding pharmaceutical industy

c) national debt; immigration

d) physician decision making; fee for service payment methods
physician decision making; fee for service payment methods
The simultaneous occurrance of physicians dominating the decision making role & fee-for-service-payments was combined with the driving motivation in the health care system to?

a) minimize cost

b) increase profits

c) provide best possible care

d) encourage federal funding for research
provide best possible care
The lack of cost consciousness and the "if it might help do it" approach to provide health care in the 1960's led to?

a) "perverse economic incentives"

b) large increases in the total Medicare bill

c) federal budget deficits

d) revolution in health insurance reimbursement
All of the above
The health care financing revolution began in ?

a) 1953

b) 1960

c) 1975

D) 1983
1983
As a result of the health care financing revolution medicare went from ?

a) restrospective payment system to a prospective payment system

b) prospective payment system to a retrospective payment system
restrospective payment system to a prospective payment system