Chapter.11 Health Care Costs And Value Exam Prep 12e

Jonas & Kovner’s Health Care Delivery in the United States, 12^th Edition

Test Bank

Chapter 11, Health Care Costs and Value

MULTIPLE CHOICE

1. Per capita spending on health care in the United States, adjusted for inflation, grew at what rate between 1960 and 2016?

A. 125%

B. 250%

C. 575%

D. 775%

1. How does U.S. health care spending as a share of GDP compare to that of other industrialized nations?

A. It is about the same as others

B. It is lower than others

C. It far exceeds others

D. It cannot be compared due to data collection differences

1. The federal government pays for more than half of the Medicaid program. The balance is paid by which of the following?

A. Low-income Americans

B. Department of Veterans Affairs

C. State governments

D. Centers for Disease Control and Prevention

1. In 2016, the typical U.S. family’s total health care spending, including insurance premiums and direct medical costs, ranked as which budget item?

A. Fourth largest

B. Smallest

C. Second largest

D. Largest

1. One definition of health care value places it at the intersection of health care spending, patients’ experiences and outcomes, and which of the following?

A. Hospital readmission rates

B. The quality of care providers deliver

C. Patients’ satisfaction with their insurers

D. Size of the uninsured population

1. Which of the following is a key challenge in the drive to define and achieve health care value?

A. A shortage of quality-measurement frameworks

B. The accelerating increase in the cost of health care

C. Increasingly good patient outcomes nationwide

D. Inability to meaningfully measure patient-centered outcomes

1. Almost a third of Medicare spending is devoted to which of the following?

A. Children living in poverty

B. Patients in their last two years of life

C. Research on chronic disease

D. Elderly patients who have suffered falls

1. Which of the following is a group of health care providers, such as physicians and hospitals, collaborating to ensure the highest quality treatment possible for a segment of the population?

A. An accountable care organization (ACO)

B. A patient-centered medical home (PCMH)

C. A fee-for-service (FFS) organization

D. A health maintenance organization (HMO)

1. The Institute of Medicine identifies which of the following as a primary source of wasteful health care spending?

A. Misdiagnoses

B. Mandatory vaccinations

C. Unneeded procedures

D. Medical errors

MULTIPLE RESPONSE

1. In a recent study the United States ranked last or near last among peer nations in which of the following? Select all that apply.

A. Health care access

B. Administrative efficiency

C. Equity

D. Patient and population health outcomes

E. Health care innovation

1. Which of the following are most likely to be among the families whose annual health care spending exceeds the average? Select all that apply.

A. Families without insurance

B. Families who are underinsured

C. Families that include someone with a chronic disease

D. Families with minimal medical needs

1. Which of the following are reasons the value of health care should be defined differently than the value of other consumer purchases? Select all that apply.

A. Patients rarely drive treatment decisions

B. Patients are usually responsible for only a small fraction of the costs of their care

C. Patients often shop for doctors just as they do for other professionals whose services they need

D. Patients benefit from the financial protection afforded by health insurance

1. Which of the following are true of a fee-for-service system? Select all that apply.

A. Fee-for-service systems compensate providers for each service performed

B. As of 2016, more than 85% of U.S. physicians reported being reimbursed under the fee-for-service model

C. Most experts agree that fee-for-service models are a major driver of high health care spending

D. Many patients prefer fee-for-service arrangements

1. Which of the following are factors that motivate medical practitioners to provide more, and sometimes too much, care? Select all that apply.

A. Providers’ anxiety over the uncertainty of outcomes

B. Difficulty of taking into account patients’ preferences and values in treatment decisions

C. Transparent information about the cost of care

D. Patients’ widespread belief that more health care must be better

MULTIPLE CHOICE

1. Which of the following is the value that third-party payers often argue they bring to the U.S. health care system?

A. Lower administrative costs

B. Reduced payments to health care providers

C. Fewer unnecessary procedures

D. Innovative quality-measurement frameworks

1. Which of the following do U.S. physicians have in common with U.S. hospital administrators?

A. They are more highly paid than peers in almost every other country

B. They are younger than in most other countries

C. They are among the smallest groups of stakeholders in the U.S. health care system

D. They are unionized at higher rates than in other countries

1. Most Medicare ACOs have one-sided risk, which means which of the following?

A. If they go over budget, they must repay Medicare a portion of the excess

B. They must pay their own malpractice insurance premiums

C. If they exceed their budget, they are not penalized

D. If they spend less than their budget, they are allowed to keep all the savings

1. The only state in the United States that has an all-hospital rate-setting system is

A. Hawaii

B. New York

C. Maryland

D. Vermont

1. Which of the following is the list of all prescription drugs a pharmacy benefit manager will dispense?

A. Formulary

B. Value-based contract

C. Benchmark

D. Index of lower-tier drugs

1. Providers in the Merit-based Incentive Payment System (MIPS) can earn payment adjustments based on their performance in four categories. Which of the following is not one of the categories?

A. Quality of care

B. Cost of care

C. Clinical practice improvement

D. Number of patients seen

SHORT ANSWER

1. Briefly discuss two reasons for concern about growth in the government’s share of health care costs.
2. Discuss the reasons that health care costs are an implicit part of national discussions about unemployment and job creation.
3. Describe recent changes in insured employees’ share of the cost of health care.
4. Explain what is meant by the common definition of health care value as “health outcomes achieved per dollar spent,” and what this definition suggests about ways of improving value.
5. Explain why different stakeholders in the U.S. health care system often have conflicting goals.

ESSAY

1. Using examples, explain how value can be achieved when the care patients are given achieves the goal that matters most to them.
2. Explain the origins of the fee-for-service (FFS) payment model and the reasons it became widespread.
3. Identify and describe the characteristics of the Patient-Centered Medical Home (PCMH) model of primary care.