Saudi Electronic University

HCM 213

Chapter 13

Multiple Choice

1)In the healthcare payment system are various stakeholders. These include:

1. 1. Contractors
   2. Patients
   3. Vendors
   4. a & c
2. The objectives of the U.S. healthcare payment system include:
   1. Access
   2. Cost
   3. Quality
   4. All of the above
3. Medicare’s value based payment demonstrations have had what effect on expenditures?
   1. Great success
   2. Fair success
   3. Little or no effect
   4. None of the above
4. Blue Cross Blue Shield got its start in: a. 1929

b.   1949

c.     1959

d.   1965

5. The Medicare program was enacted as part of the Social Security Act in: a. 1955

b.   1960

c.     1965

d.   1967

6. Health Maintenance Organization (HMO) is:
   1. A perspective payment method
   2. A legally Incorporated organization that offers health insurance
   3. An organization that rations care
   4. A rating method used by indemnity insurers
7. Value Based Purchasing is:
   1. A monthly payment by a person to an insurer
   2. A method of reimbursement based on payment for services rendered
   3. A method to control costs through monitoring and prescribing
   4. A payment methodology designed to provide incentives to providers for delivering quality care at lower costs

8. Never events are:
   1. Adverse patient outcomes due to provider negligence that are not typically not reimbursed
   2. Methods of rewarding quality of care
   3. Quality populations based on payment
   4. Payment strategies for reducing health care spending
9. Accountable care organizations performance is measured by:
   1. Patient experience
   2. Care coordination
   3. Preventative health care
   4. All of the above
10. Hospital reimbursement by Medicare includes:
    1. Case rates
    2. Ambulatory payment classifications
    3. Cash Rates
    4. a & b

True or False

1. A payor may be a regulator. True or False?