Health Insurance Challenges for Employed and Unemployed Individuals

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Questions and Answers

What are the factors that contribute most to premature death?

  • Genetic
  • Medical Care
  • Lifestyle And Behaviors (correct)
  • Social and Environmental Factors

In the 1950s, there was a change in where healthcare services were provided compared to the 2000s. What was this change?

  • Movement towards outpatient centers
  • Movement towards hospitals (correct)
  • Movement towards doctors offices
  • Movement towards patient's homes

Which mode of paying for healthcare is most prevalent?

  • Government Financing and Subsidies
  • Employment-Based Private Insurance (correct)
  • Out of Pocket
  • Individual Private Insurance

Which group is more likely to be employed but uninsured?

<p>People of color (B)</p> Signup and view all the answers

Which group is more likely to be unemployed but uninsured?

<p>People who have to pay 100% of premium on former employer's plan (C)</p> Signup and view all the answers

What is the main difference between regressive and progressive forms of financing?

<p>Regressive forms take a falling percentage of income as income increases (C)</p> Signup and view all the answers

Which type of insurance rate setting allows healthier groups to pay less for their insurance premium?

<p>Experience Rating (B)</p> Signup and view all the answers

Which part of Medicare covers hospital care?

<p>Medicare Part A (C)</p> Signup and view all the answers

What is the financing source for Medicare Part B?

<p>Federal revenues (D)</p> Signup and view all the answers

What is the eligibility requirement for Medicaid?

<p>Citizens with income at or below 138% of the Federal Poverty Level (D)</p> Signup and view all the answers

What is the most popular type of health insurance coverage in the 1900s?

<p>Indemnity (A)</p> Signup and view all the answers

Which type of health insurance coverage offers the widest choice of providers and hospitals?

<p>PPO (D)</p> Signup and view all the answers

What is the purpose of a Health Savings Account (HSA)?

<p>To provide tax-free savings (B)</p> Signup and view all the answers

What is the main limitation of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)?

<p>Premiums may be unaffordable (D)</p> Signup and view all the answers

Which factor contributes to health care inflation?

<p>Reimbursement System (B)</p> Signup and view all the answers

What is the Medicare Resource Based Relative Value Scale (RBRVS)?

<p>A method to estimate physician payment based on time and effort (A)</p> Signup and view all the answers

What was one problem with the Fee For Service (FFS) payment model?

<p>Doctors could unilaterally set payment prices (A)</p> Signup and view all the answers

What is the current focus of cost containment in healthcare?

<p>Negotiation between payers and providers (C)</p> Signup and view all the answers

Which factor contributes the least to premature death?

<p>Medical Care (C)</p> Signup and view all the answers

Which mode of paying for healthcare has become more prevalent in order to control premium costs?

<p>Out of Pocket (B)</p> Signup and view all the answers

Which mode of paying for healthcare is very expensive since there is no group discount?

<p>Individual Private Insurance (A)</p> Signup and view all the answers

Which group is more likely to be employed but uninsured?

<p>People of Color (POCs) (A)</p> Signup and view all the answers

What is the financing source for Medicare Part B?

<p>General tax revenues (C)</p> Signup and view all the answers

What is the main limitation of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)?

<p>It only provides temporary coverage (D)</p> Signup and view all the answers

Which type of health insurance coverage requires a PCP and has limited choice of physicians?

<p>HMO (C)</p> Signup and view all the answers

What is the main limitation of the Health Maintenance Organizations (HMOs) plan?

<p>Limited choice of physicians (A)</p> Signup and view all the answers

Which type of health insurance coverage allows enrollees to self-refer to another physician and has a wide choice of providers and hospitals?

<p>PPO (A)</p> Signup and view all the answers

What is the main limitation of the Point of Service (POS) plan?

<p>Co-payments for non-network care are high (A)</p> Signup and view all the answers

Which type of insurance rate setting allows healthier groups to pay less for their insurance premium?

<p>Experience Rating (A)</p> Signup and view all the answers

What is the financing source for Medicare Part A?

<p>Social security taxes (D)</p> Signup and view all the answers

What is the eligibility requirement for Medicaid?

<p>citizens with an income at or below 138% of the Federal Poverty Level and any other conditions set by individual states (C)</p> Signup and view all the answers

What are the financial barriers to insurance?

<p>Lack of Insurance (D)</p> Signup and view all the answers

Which type of payment model involves an established rate to cover a person's medical care for a specified time?

<p>Capitation (D)</p> Signup and view all the answers

What is the main purpose of the Medicare Resource Based Relative Value Scale (RBRVS)?

<p>To correct for bias in physician payments (C)</p> Signup and view all the answers

What is the current focus of cost containment in healthcare?

<p>Negotiation between payers and providers (D)</p> Signup and view all the answers

What is one challenge of setting fair rates based on patient health risks in risk-adjusted capitation?

<p>Determining the estimate time and effort required for each medical service (C)</p> Signup and view all the answers

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