has 3000 final

1.

1 point

Employers are cautious about offering mental health benefits because:

mental health spending increased 50% between 1986 and 1990

some providers designed and marketed treatment programs that matched benefit levels

they are concerned that benefit dollars will be consumed by the "worried well" rather than the severely ill

all of the above

2.

1 point

Which of the following is NOT one of the results of the managed care "backlash" that began in the late 1990's:

Capitation has become an increasingly popular method of compensating physicians

More than half of the states passed patient protection legislation

More employers are allowing employees to make personal decisions about their coverage

Many managed care plans have eliminated the "gatekeeper" requirement

3.

1 point

Inpatient treatment for mental health disorders:

Is no longer consider to be appropriate

Has been a consistent and effective service since the 1600's

Is generally covered by health insurance to the same extent as other illnesses and injuries

Increased dramatically following development of the first effective psychoactive medications in the 1950's

Reached its peak volume in the mid-1950's

4.

1 point

Historically, factors contributing to growth in total health care spending have included all of the following except

additions of advanced technology

higher deductibles and copayments

reimbursement incentives

specialized medicine

5.

1 point

What is the main focus of public health?

The health status of individuals

The health status of the general population

Diagnosis and treatment of the general population

Diagnosis and treatment of individuals

6.

1 point

Long-term care is best described as:

home-based care for physically disabled adults and children

nursing homes for the frail elderly

hospital stays lasting more than 30 days

services provided in both home and institutional settings for persons of all ages with varying levels of medical, social, and personal care needs

7.

1 point

Which of the following is cited by the text book as one of the main challenges for the future of mental health care?

All of the above

Resources are often allocated based on outdated beliefs held by politicians and psychiatrists rather than on current evidence

We do not have the capability to diagnose and treat mental disorders as effectively as other illnesses

We need to increase payments to providers based on the units of service provided

Managed care programs are reducing the availability of services to people with severe mental illness

8.

1 point

Which of the following is true, according to your text?

Mental illness cannot be classified into specific diagnoses and therefore is not conducive to targeted treatments

Nearly all Americans who suffer severe mental illness are receiving appropriate treatment

Mental disorders can now be diagnosed and treated as effectively as physical disorders

Major psychiatric disorders are developmental and can be prevented through early intervention

9.

1 point

Relative to the federal Department of Health and Human Services (DHHS), the national Public Health Service is:

about the same budget amount as Medicare and Social Security

Hugely overshadowed by Medicare and Social Security

The agency that oversees the DHHS

Only indirectly related since it has been transferred to the new Department of Homeland Security

10.

1 point

Managed care:

None of the above

Has not been effective in controlling the cost of mental health services

Has not been a factor in the delivery of mental health services

Has been effective in reducing mental health care costs even while expanding benefits

Is rarely used for mental health services by Medicaid programs

11.

1 point

Which of the following is NOT true, according to your text:

Only about 10% of early deaths can be prevented by medical treatment while public health approaches could help prevent 70%

The current medical care system fails to provide effective preventive services even when they are demonstrated to be the most cost-effective procedures available

In our system, new treatment technologies are implemented despite serious reservations about their efficacy and cost-effectiveness

All of the above statements are taken from the text

12.

1 point

When comparing nursing home regulation and oversight with that of hospitals, which of the following is correct?

Nursing homes are licensed by the states, hospitals are not

Nursing homes are not accredited by the JCAHO

There is a federally legislated nursing home resident bill of rights, but not a federal law enacting a hospital patients' bill of rights

Nursing homes are not subject to Medicare and Medicaid guidelines

13.

1 point

The Balanced Budget Act of 1997:

Tightened coverage requirements for Medicaid making fewer children eligible

Increased Medicare payment rates to doctors and hospitals

Required Medicare beneficiaries to join HMO's

Ensured that individuals who change jobs will be able to continue their health insurance

Payment cuts were partially reversed in 1999

14.

1 point

Which of the following have managed care plans used to control costs:

Requiring patients to have a referral from their primary care physician before being covered for specialty services

Paying providers a fixed amount per member per month regardless of how much service a particular member uses

Establishing co-payments that require patients to pay for a portion of the cost of certain services

Establishing formularies that give beneficiaries financial incentives to use generic drugs or specified brand name drugs

All OF THE ABOVE

15.

1 point

Which of the following is NOT true of the Medicaid program:

It was enacted at the same time as Medicare, in the mid 1960's

Coverage is more comprehensive than Medicare, but more difficult to qualify for because of income limits

Medicaid is the largest payer for nursing home care

Medicaid is administered and financed by the states, with matching funds from the federal government

All of the above are true

16.

1 point

Which of the following is typically carried out by STATE government, rather than federal or local?

Licensing of health care providers

Administration and funding of Medicare

Immunization and screening clinics

Establish and enforce local health codes

Setting research priorities and funding them

17.

1 point

The hospice movement is concerned with care for the terminally ill patient. Which of the following are true of hospice care?

decreasing costs of care for the terminally ill by limiting the use of expensive technology

providing an alternative to the curative/intervention approach in the care of the terminally ill

providing state-of-the-art pain relief interventions while supporting the patient and his/her family through the life-death transition

Medicare covers most costs of Hospice services

all of the above

18.

1 point

Which of the following is true regarding the distribution of our national health care expenditures in the year 2008?

Hospitals consumed more than half of the total

Nursing home care was the second largest area for expenditures

Prescription drug costs jumped to nearly one-fourth of the total

Physician services totaled nearly $500 billion; about 21% of total

Nobody knows where the money went

19.

1 point

In recent years many managed care plans have backed away from some of their stringent control mechanisms such as capitation and "gatekeeper" requirements because:

They were so profitable that they could afford to back off

Strong consumer backlash resulted in pressure from customers and politicians

They felt sorry for doctors and hospitals

These controls weren't saving any money

20.

1 point

How does the term "carve-outs" apply to mental health services?

For some forms of mental illness, surgery is the most effective treatment

Managed care plans often shift risk by contracting with external vendors to provide services

Employers can select employees with mental illness for exclusion from health insurance coverage

States are prohibited from using this approach to managing Medicaid mental health expenditures

Mental health coverage is generally excluded from most health insurance plans

21.

1 point

Which of the following is NOT a major responsibility of public health?

Educating the community about environmental and behavioral factors associated with disease and injury

Monitoring and detecting infectious and toxic agents

Clinical services for hard to reach populations

Monitoring the quality of hospitals, nursing homes, and other providers

All of these are major responsibilities of public health

22.

1 point

Which of the following is correct regarding Assisted Living Facilities in the U.S.?

They are an alternative to nursing homes for patients who need skilled nursing care

They are consistently licensed and regulated by the states

Most costs are paid directly by the residents rather than by insurance or government programs

The number of residents is expected to increase by about 50% by 2025

All of the above are correct

23.

1 point

An aim of managed care is to transfer some measure of financial risk to providers and, to a lesser extent, to patients. One of the ways that financial risk is transferred to patients is by:

using fee withholds

monitoring provider practice patterns

imposing a financial penalty on patients who use providers outside the managed care network without pre-arrangement

requiring the use of clinical pathways

24.

1 point

According to your text, which of the following is correct regarding long-term caregivers?

They are typically paid about the same amount as acute hospital workers

There are enough workers to meet the needs of the long-term care industry

They are traditionally considered to have a lower status than acute health care workers

They typically have high opportunities for education and career mobility

All of the above

25.

1 point

The prospective hospital reimbursement system introduced in 1983 was an effort to:

achieve cost savings by reducing excessive hospital lengths of stay

pay physicians on a per patient admission basis

provide incentives to hospitals for achieving economy in patient care costs, based upon diagnoses

a and c

all of the above

26.

1 point

Total expenditures on health care in the U.S.:

Are about 5% of our Gross Domestic Product

In 1990 were almost ten times what they were in 1970

Decreased during the 1990's

Were nearly $5,000 per person in the year 2008

All of the above are correct

27.

1 point

According to studies cited in you text, which of the following occurred in the first few years following implementation of the DRG system of paying hospitals for services provided to Medicare inpatients?

No increase in the number of patients who needed readmission to the hospital after discharge

An overall reduction of mortality rates for patients

Significant slowing in the rate of hospital cost growth

All of the above

Average lengths of stay shortened by almost one-fourth

28.

1 point

More than 98% of Americans who have health insurance through employer sponsored plans are now members of managed care plans. Why did managed care plans become so popular?

hospitals lobbied Congress to mandate employers to offer managed care plans to their employees

physicians pushed for the standardization of treatment protocols

consumers demanded a more organized system

they were able to significantly slow down the rate at which health care costs were increasing

29.

1 point

Which of the following is typically carried out by FEDERAL agencies rather than state or local?

Monitoring and inspection of providers

Administration and primary funding of Medicaid

Operating mental health hospitals and clinics

Supporting biomedical and health services research

30.

1 point

Persons age 65 and older consume substantially more health services than younger people. The number of persons age 65 and older in the U.S.:

Is expected to nearly double between 2008 and 2030

Increased rapidly by 2008 because of the baby boomers

Is not changing very much because people over 85 are dying off as rapidly as new people are reaching age 65

Is now about 25 million

None of the above are correct

31.

1 point

About how much of total healthcare expenditures in the U. S. are for prevention rather than treatment?

35%

25%

Less than 5%

50%

15%

32.

1 point

Which of the following is correct regarding Home Care in the U.S.?

Medicare is the largest single payer

Medicare will not pay for home care services unless the patient is confined to their home

Most home care is provided informally by family members and friendsand utilization controls

Licensure requirements vary from state to state, but most agencies are licensed so they can get payments from Medicare

All of the above are correct

33.

1 point

Insurance coverage for mental illness treatment has lagged behind coverage for other types of health care because:

myths persist that the costs of psychiatric care are uncontrollable and unpredictable

it is generally agreed that most people wouldn't use their benefits anyway for fear of stigmatization

employers view offering this type of coverage as opening themselves to lawsuits

epidemiologic evidence suggests that outcomes of treatment are generally poor

34.

1 point

Which of the following is NOT true regarding the sources of funds for our national health expenditures in the year 2008?

Public funds, mainly through Medicare and Medicaid, contributed more than 45% of the total

The federal government financed about 35% of the total

Consumers paid more than 20% of the total directly out-of-pocket for care

Private health insurance covered about one-third of the total

Ultimately, consumers paid for all of it through taxes, insurance premiums, direct payments, and as part of the cost of other products and services

35.

1 point

Which of the following is correct regarding Skilled Nursing Facilities in the U.S.?

Occupancy rates are rising rapidly

Average cost per resident is almost $100 per day

Medicaid is the largest payer

Since most residents are elderly, Medicare pays for most long-term care

All of the above are correct

36.

1 point

Which of the following is true according to your text?

Most working Americans have private health insurance provided by their employers.

Americans have better health outcomes than citizens of any other country

none of the above

Nearly 50% of Americans are uninsured or underinsured.

37.

1 point

Managed care strategies to hold down the total amount they pay out for services fall into two general categories: (1) control the number of services they must pay for, and (2) control the amount they pay for each unit of service. Which of these strategies would help control the number of services used?

Negotiating a discounted fee scale with physicians

Requiring approval from the plan prior to hospitalization or expensive procedures

Contracting with a select group of hospitals

Establishing significant co-payments and deductibles

Both b and d

38.

1 point

In the battle for allocation of U.S. health resources, which of the following is NOT correct?

The system gives providers financial incentives to practice prevention rather than diagnosis and treatment

The public is generally more interested in high tech diagnostic and therapeutic medicine than in prevention and health promotion

Public health suffers from a poor public image

The public lacks knowledge and appreciation for the mission and activities of public health

39.

1 point

Which of the following is true about private long term care insurance in the U.S.:

most Americans have it

it is a small but growing source of payment for long term care services

it is unnecessary because Medicare pays for long term care

it will only pay for care in a hospital or skilled nursing facility

40.

1 point

Which of the following factors increases the demand for formal long-term care services?

women working outside the home

aging population

improving medical technology

greater consumer awareness of alternatives

All of the above

41.

1 point

Which of the following is NOT true with regard to the Medicare program:

Long term nursing home care is covered

Many beneficiaries purchase private insurance to fill the gaps in Medicare coverage

Part A is automatic for Social Security recipients at age 65, Part B is voluntary

Part A is financed by payroll taxes on both workers and employers

Part B provides coverage for most physician services and is partly financed by premiums charged to beneficiaries

42.

1 point

PPO's:

Are a type of HMO

Enrolled more than 55% of covered workers in 2010

Are not considered to be managed care because they do not use control mechanisms such as preauthorization or utilization review

Differ from HMO's in that they do not have a contracted list of providers that members are required or strongly encouraged to use

43.

1 point

Community Mental Health Centers:

All of the above are true

Were an important part of the federally funded social programs instituted during the 1960's and 70's

Focused resources on improved patient outcomes

Were strongly supported by advocacy groups such as the National Alliance for the Mentally Ill

Significantly improved access to appropriate services for people with severe mental illness

44.

1 point

Which of the following is true of DRG's:

They encourage hospitals to see that each Medicare inpatient is treated as efficiently as possible

They set a maximum length of stay for Medicare patients

They set doctor fees at a fixed amount for each case

They give hospitals financial incentives to convert cases from inpatient to outpatient

45.

1 point

Health insurance in the U.S.:

First came into existence in the 1970's following adoption of the HMO Act

Is less expensive today than it was ten years ago

Does not really fit the term "insurance" because it pays for predictable, routine events

Is generally purchased by individuals rather than by groups

Is provided by more than 80% of employers to their employees

46.

1 point

While persons may need long-term care at any age, older adults represent the largest population group requiring long-term services. The population 85 years and older in the U.S.:

Is expected to increase by about 20% between the years 2007 and 2020

Is declining because of the high mortality rate at that age

Is expected to be more than 19% of the total population by 2020

Currently numbers about one million people

47.

1 point

National Health Expenditures in the United States:

make up about one of every six dollars generated by the economy (GDP)

all of the above are true

none of the above are true

stayed at about the same percentage of GDP between 1992 and 2000

increased by more than one trillion dollars between 2000 and 2008

48.

1 point

Which of the following is NOT correct currently regarding access to mental health services in the U.S.?

Decisions regarding the distribution of resources are generally controlled by mental health professionals in our communities

Myths persist regarding the nature and treatability of mental illness

About half of people with severe mental illness use mental health services

Nonparity in insurance coverage for mental illness is a factor

Less than one-third of adults with diagnosable mental disorders receive treatment

49.

1 point

During the 1980's Medicaid expenditures almost tripled. Which of these initiatives have states used in attempting to control increased Medicaid costs?

Voluntary managed care enrollment

DRG payment systems

All of the above

Mandated client enrollment in managed care plans

50.

1 point

Health maintenance organizations, or HMOs, differ from the indemnity insurance system by:

reimbursing either the provider or member for the costs of care but taking no responsibility for providing care

developing cost-based premiums for their beneficiaries

not requiring providers to share financial risk

taking responsibility for both financing and delivering health care services to a defined group of beneficiaries