-What are examples of a government-funded health insurance programs?
Medicare, Medicaid, and CHIP
-In 2019, which programs comprised a total of 25% of the federal budget?
Medicare, medicaid, CHIP, Market place subsidies
what is “fee for service”
volume of service paid to provider
- What were the top two Medicare benefit payments in 2014
Hospital inpatient services and private insurance
- What were the highest and the lowest Medicare expenditures in 2013
Acute care and mental health
- In 2019 Medicaid provided coverage to 1 in 5 Americans, which makes it the nation’s largest public health insurance program. T/F
true
- True or False? The first pre-payment plan to cover physician services was Medicare.
false
- True or False? In 1983, Congress passed a prospective payment bill under which hospitals are paid a set amount for each patient in any of the established disease categories and Diagnosis-Related Groupe (DRGS).
true
- True or False? The first managed care insurance programs were started with PPOs: Kaiser Permanen in Califomia and Group Health Cooperative in Washington State.
false
- True or False? About 85% of those offered health insurance through their employer actually enroll.
false
- In an effort to control rising healthcare costs, both public and private health insurance programs have moved to _____
capitation
- The
______
program is a federal health program for people aged 65 years and
older, certain disabled people younger than 65, and any adult with permanent kidney failure (end-stage renal disease) or amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease).
Medicare
____ is the federal-state cooperative health insurance plan for people who are
not eligible for health insurance through an employer and who cannot afford to buy health insurance through the Marketplace.
Medicaid
- Private funding is primarily through private health insurance, with what percentage of Americans having employer-sponsored health insurance in 2015?
57%
- Health care in the United States is funded through a variety of private payers, as there are no public programs available in this country. T/F
false
- Capitation as a method of reimbursement is best described as
amount paid to the provider for medical
service
- The traditional method of reimbursement for health services before the passage of the Affordable Care Act was fee-for-service. T/F
true
- Examples of government or public health insurance programs include
Medicare, Medicaid, and
TRICARE
Medicaid is the federal-state cooperative health insurance plan for which group of people?
Individuals with low income
- Medicare and Medicaid are government or public health insurance programs that benefit 1 in 10
Americans. T/F
false
- What best describes a Health Maintenance Organization (HMO)?
HMO does not cover out-of-network care except an emergency
- The first managed care insurance programs were started with HMOs. T/F
true
- Managed Care Organizations are divided primarily into HMOs, PPOs, and Exclusive Provider Organizations. T/F
true
- In what year was Medicare expanded to include those with certain disabilities, chronic kidney disease, and ALS?
1972
