Midterm Help – HMO

Daniel Kevins

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Question 1 (5 points)

HMO insurance benefit options include:

Question 1 options:

HMO/POS.

HMO/Network.

HMO/Group.

all of the above.

Question 2 (5 points)

Which is a delivery system approach for long-term care?

Question 2 options:

Skilled Nursing

Home Health

Meals-on-Wheels

All of the above

Question 3 (5 points)

Which of the following is correct about Medicare reimbursement?

Question 3 options:

Medicare Part A pays for hospital services; Medicare Part B pays for physician services; Medicare Part C does not pay non-covered services; Medicare Part D pays prescription drug benefits.

Medicare Part B pays for hospital services; Medicare Part A pays for physician services; Medicare Part C does not pay benefits; Medicare Part D pays prescription drug benefits.

Medicare Part A pays for hospital services; Medicare Part B pays for physician services; Medicare Part C does not pay benefits; Medicare Part D pays prescription drug benefits.

None of the above is correct.

Question 4 (5 points)

Which of the following is not a type of hospital according to its type of service?

Question 4 options:

Question 5 (5 points)

Which of the following best defines the credentials of clinical psychologists?

Question 5 options:

Question 6 (5 points)

Consider the trend for more and more ambulatory care services in the U.S. What is/are the key factor(s) driving this trend?

Question 6 options:

Cost reduction

Patient and physician preference

Insurance coverage provisions

All of the above

Question 7 (5 points)

Which of the following is/are true about the licensed psychiatric social worker?

Question 7 options:

Social workers have Master’s degrees, MSWs.

Social workers assume counseling roles but do not prescribe.

Both A and B are true.

Neither A nor B is true.

Question 8 (5 points)

Which type of hospital has the shortest length of stays?

Question 8 options:

Question 9 (5 points)

What are some of the unique aspects of managing health care in a rural setting?

Question 9 options:

Medical shortages areas (less than 100 people per square mile)

Rural exemptions to allow P.A.s to practice without direct physician supervision

Higher fee schedules for lower volumes of patients

All of the above

Question 10 (5 points)

How is “quality” defined within health care organizations?

Question 10 options:

Internal and external benchmarks

Patient satisfaction surveys

Clinical outcomes

All of the above

(11) Discuss three settings for ambulatory care in the U.S. What kind of care is delivered in each? Who are the health care providers in the settings you have chosen?

(12) Discuss the various settings and arrangements for delivering mental health services. Your answer should define key types of diagnoses and the providers that deliver the care.

(13) Define and discuss retrospective and prospective payment methods in U.S. health care. Have these methods been effective? What problems have been noted with each? Support your answers.



(14) Discuss the three primary sources of organizational power in hospitals. How should these three interact in leading a hospital?



(15) Discuss, in your own words, the origins of government involvement in health care delivery in the United States. What were some of the key milestones and their impacts? What are at least 5 key responsibilities of health care administrators? Explain each responsibility and why it is important.

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Daniel Kevins

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