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</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</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</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</p> Signup and view all the answers

    Which part of Medicare covers hospital care?

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

    What is the financing source for Medicare Part B?

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

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

    <p>Indemnity</p> Signup and view all the answers

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

    <p>PPO</p> Signup and view all the answers

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

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

    Which factor contributes to health care inflation?

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

    What is the current focus of cost containment in healthcare?

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

    Which factor contributes the least to premature death?

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

    Which group is more likely to be employed but uninsured?

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

    What is the financing source for Medicare Part B?

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

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

    <p>HMO</p> Signup and view all the answers

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

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

    What is the financing source for Medicare Part A?

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

    What are the financial barriers to insurance?

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

    What is the current focus of cost containment in healthcare?

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

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