Business of Healthcare and Health Policy Practice Test

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• Who are the insurers & payers in the US healthcare system?
• Which statement best describes liquidity in a hospital setting?
• What are the 4 models of care within HMOs?
• What is HEDIS used for in health care quality measurement?
• What is a typical objective of managed care organizations in regulating providers?
• Which statement best describes individual health insurance?
• Which measure is commonly used as an access indicator in health policy analysis?
• What is the purpose of the difference-in-differences approach in policy evaluation?
• Medicare Part B covers which type of services?
• Who is eligible for Medicaid?
• What is the purpose of patent exclusivity in pharmaceuticals from a policy perspective?
• Medicaid reimbursement is determined by which level of government?
• Which statement best describes how payer mix and reimbursement rates influence hospital profitability?
• Hospice care is included under Medicare Part A.
• What is included in the Private Sector?
• What best describes Managed Care Organizations (MCOs)?
• Which of the following best defines employer-sponsored insurance?
• How do social determinants of health influence policy design and cost outcomes?
• In value-based care, what is a core incentive and a common challenge?
• What is the role of the Energy and Commerce Committee?
• What is included in the Private Sector?
• Which of the following is an example of a state advisory board?
• Which group is listed as a lobbyist in healthcare policy?
• During a disease outbreak, how does surveillance data primarily support decision making?
• What is the typical impact of primary care on health system costs?
• Which category of organization is commonly involved in evaluating and ensuring quality standards in healthcare?
• Under what condition can recipients of the Indian Health Service receive private sector treatment?
• What are the current challenges for PAs in the healthcare system?
• Which analysis assesses the expected budget impact for a payer or system when evaluating a new healthcare intervention?
• What are the goals of healthcare policy?
• What is included in the Public Sector?
• Which feature commonly accompanies a High Deductible Health Plan to enable tax-advantaged savings?
• What is the role of Diagnosis-Related Groups (DRGs) in hospital reimbursement under prospective payment systems?
• What are types of providers in US healthcare?
• Which arrangement reimburses employees for medical expenses and is funded by the employer?
• Which statement best describes providers in the US health system?
• What are the types of Managed Care Organizations (MCOs)?
• Which statement best contrasts the revenue cycle with the general ledger?
• Which entities are typically involved in influencing health policy besides the government?
• Which service is NOT covered by Medicare?
• Which statement best captures the role of ethics in health policy?
• CLIA is primarily concerned with regulation of which of the following?
• Which statement best describes the main components and disruption risks of the healthcare supply chain?
• Which statement best describes coinsurance?
• CHIP is designed for which group?
• Which population is served by the Indian Health Service?
• What are institutional advisory boards to help PAs in health policy?
• Which are the major House of Representatives committees that influence U.S. healthcare?
• What is the primary purpose of patient matching in health information exchange?
• Which statement best describes managed care?
• The FDA's primary regulatory function includes which of the following?
• Which payment method pays a daily rate?
• Medicare Part C plans are offered by which type of organization?
• Who are the consumers in the US healthcare system?
• Which mechanism best aligns physician incentives with hospital strategy?
• Medicare Part A primarily covers which type of care?
• Which description of incentives is correct for fee-for-service and capitation?
• What is a key consideration in hospital budgeting and capital planning?
• Payer contracts use risk adjustment to achieve what?
• Which statement about Military Health Service is correct?
• Which statement best describes Public Health Systems?
• Which are examples of health systems included in the public health system?
• Under EMTALA, which requirement applies to any hospital with an emergency department that accepts Medicare?
• Which entity sponsors biomedical research and medical training?
• Explain capitation risk adjustment and the purpose of risk adjustment methodologies (e.g., HCCs).
• Which of the following is NOT a typical provider compensation method used by HMOs?
• Under the ACA, Medicaid expansion occurred?
• Under what condition can Veterans Affairs health service recipients receive private sector treatment?
• Who are the healthcare policy makers?
• Which are examples of healthcare financing?
• Which of the following best describes Exclusive Provider Organizations (EPOs)?
• Who is eligible for CHIP?
• Who are the providers in the US healthcare system?
• What is the primary purpose of public health surveillance data in policymaking?
• What is value-based purchasing and how do payer organizations implement it?
• Medicaid eligibility is primarily based on which factor?
• Which program focuses on providing health coverage to low-income individuals?
• Care coordination across different care settings reduces errors by focusing on
• Which power is held by state boards regulating providers?
• The FDA also regulates which product category?
• Which statement describes what the Veterans Affairs health service covers?
• Differentiate population health and public health approaches in policy.
• Which method is commonly used to evaluate health policy interventions?
• Which item is explicitly described as formal public commentary as part of rulemaking procedures?
• Which combination of practices best supports fair access and equity in health policy design?
• How can policy incentivize care coordination?
• How does patient experience influence reimbursement and market competitiveness?
• Which statement best describes coinsurance?
• Which entities are typical examples of suppliers in U.S. healthcare?
• Which is true about the Prison healthcare system?
• Which hospital payment method reimburses a fixed amount per case?
• Under HIPAA, which elements are key to protecting privacy and enabling care coordination and research?
• Which committee handles tax policy and Medicare Part A?
• Define price transparency and discuss its potential market impact.
• Which statement best describes the relationship between deductibles and premiums in an HDHP?
• Which description accurately defines a High Deductible Health Plan (HDHP)?
• Which standards support health information interoperability and data exchange?
• What is a bundled payment model and provide a typical example?
• EMTALA requires which of the following for ED patients at hospitals that accept Medicare?
• What is included in the Public Sector?
• Why is risk adjustment important in capitation systems?
• What is the typical Medicare reimbursement percentage?
• Which statement best describes individual insurance compared to employer-sponsored insurance?
• Under HIPAA, what are the core requirements for protecting health information in practice?
• How is Medicaid coverage determined?
• Which statement best describes HIPAA protection?
• What does cost-effectiveness analysis compare?
• Which statement best describes a Health Reimbursement Arrangement (HRA)?
• Which services are required to be covered by CHIP?
• What is Capitation?
• In policy terms, how does primary care differ from specialty care in terms of accessibility and cost?
• Under the ACA, which plan must cover preventive services at no additional cost?
• What is a Section 1115 waiver and how does it affect Medicaid policy experimentation?
• Which of the following are examples of organizations that act as providers?
• Under the ACA, until what age can a child remain on a parent's health plan?
• In evaluating new healthcare interventions, how are economic evaluations typically used to inform policy decisions?
• Capitation is best described as?
• Which statement accurately reflects healthcare financing options?
• Which of the following is an example of a federal advisory board?
• Which statement describes a provision of the ACA?
• Which group is described by the term healthcare technologists and technicians?
• Which of the following is NOT listed as a current healthcare policy topic in 2026?
• Describe the role of healthcare analytics in population health management.
• Which statement accurately describes Point of Service (POS) plans?
• What are the federal regulating bodies in healthcare?
• Which of the following best represents organizations that provide medical care?
• Which mechanism do hospitals use to regulate individual providers?
• What is a potential effect of price transparency on payer-provider contracts?
• How should policymakers handle trade-offs between efficiency and fairness?
• Who determines Medicaid coverage in the United States?
• What are the core objectives of health policy analysis and how are they measured?
• Which of the following is an example of government healthcare financing programs?
• How did the Affordable Care Act aim to expand coverage, and what mechanisms did it use?
• What are essential health benefits under the Affordable Care Act?
• What is the primary goal of managed care organizations (MCOs)?
• What is an insurance copay?
• How can health policy influence innovation in digital health and telemedicine?
• Which of the following is NOT an eligibility criterion for Medicare?
• Under the ACA, what does guaranteed issue require?
• Which description best captures the federal role in health policy?
• Which feature characterizes a Health Savings Account (HSA)?
• What are the 3 types of insurers & payers?
• Which of the following is NOT a model of care within HMOs?
• Medicare Part D provides coverage for what?
• Medicare Part C plans are best described as plans offered by private organizations that include which of the following?
• What is Health Technology Assessment (HTA) and how does it influence reimbursement decisions?
• What does COBRA provide for employees and their families after changes in employment?
• What percent of Medicare reimbursement do PAs receive?
• Which program among the following is designed specifically for children in low-income families?
• Which agencies are overseen by the Department of Health and Human Services?
• Who are the suppliers in the US healthcare system?
• Describe how Medicare, Medicaid, and private insurance differ in the US regarding eligibility and funding.
• In the US healthcare framework, which choice best identifies the payer or insurer role?
• Which plan is characterized by allowing access to both in-network and out-of-network providers with a fee-for-service model and discounts for in-network care?
• Which are essential elements of health information technology interoperability?
• What is cost-shift in healthcare pricing and what drives it?
• What is the average reimbursement for Medicaid?
• What is the premium for Medicaid?
• What are the responsibilities of the Department of Health and Human Services (HHS)?
• Which Medicare Part covers hospital care and related post-acute services?
• What practice is a key ethical consideration in policy design?
• Which group best describes healthcare practitioners in U.S. healthcare?
• Which workers are considered healthcare support providers?
• Which entity regulates the criteria for reimbursement of services?
• What is the role of health policy in addressing health disparities and social determinants of health (SDOH)?
• What is the role of antitrust review in healthcare markets?
• Which of the following describes what the Indian Health Service covers?
• Which of the following is NOT a provision of the ACA?
• What is CHIP?
• How much did the US spend on health expenses in 2024?
• What is an insurance premium?
• Which method do hospitals use to determine Medicare reimbursement rates?
• Which statement about Exclusive Provider Organizations (EPOs) is accurate?
• Which law prohibits self-referrals?
• What is a main goal of policy design for continuity of care?
• What is a major benefit of health IT interoperability?
• What is the role of a hospital balance sheet?
• Which act protects medical records and health information?
• Which approach best aligns with ethical resource allocation in health policy?
• What is an insurance deductible?
• Which of the following best defines short-term insurance?
• Which statement correctly describes the relationship among the income statement, balance sheet, and cash flow statement?
• Which statement best captures the trade-off in regulations of drug pricing and pharmaceutical innovation?
• What is the primary purpose of antitrust review in healthcare markets?
• What are QALYs and ICERs, and how are they used in economic evaluations?
• What does the ACA require of employers with 50 or more employees?
• Who are the policy-makers & regulators in the US healthcare system?
• Which group is NOT one of the three types of insurers & payers?
• What is the primary way PPOs compensate providers?
• What is a potential impact of higher market concentration on prices in healthcare markets?
• Explain risk pooling and how adverse selection can destabilize health insurance markets.
• What is a challenge of value-based pharmaceuticals and tiered formularies?
• Which challenges are commonly cited in implementing value-based care?
• What is the role of the Ways and Means Committee?
• What is a primary risk associated with DRG-based prospective payment systems?
• Which data category is typically used to inform health policy decisions?
• What does the Department of Health and Human Services oversee?
• What are Health Maintenance Organizations (HMOs)?
• Which statement best describes a Preferred Provider Organization (PPO)?
• Medicare reimburses physicians using which metric?
• Which metrics are commonly used to assess equity in health policy outcomes?
• Which of the following are examples of suppliers in US healthcare?
• Which law prohibits financial incentives for referrals?
• Which incentive mechanism can promote care coordination within hospital strategy?
• What is coinsurance?
• Which statement best describes Accountable Care Organizations (ACOs) and how they share savings?
• Which of the following is NOT typically part of a payer contracting strategy?
• What is covered by CHIP?
• Which entity is primarily responsible for accrediting and setting quality standards for hospitals and clinics?