ATI RN
Economic Foundation of the US Healthcare Delivery System Questions
Question 1 of 5
Which best describes a flaw of indemnity plans?
Correct Answer: D
Rationale: Indemnity plans paid all the costs of covered services provided to the enrollee. The enrollee enjoyed free choice of provider and services. They preserve the enrollee's right of choice and allow the person to manage his or her own health care. These plans became very costly because there were no incentives for cost containment. Today, cost-sharing efforts (e.g., copayments, deductibles) help contain costs. Blue Cross and Blue Shield continue to be a provider of health insurance.
Question 2 of 5
Which best describes how having health insurance has affected lifestyle behaviors?
Correct Answer: C
Rationale: Funding for behavioral changes is limited, inadequate, or unavailable. Weight loss programs or smoking cessation programs are not reimbursable treatment regimens although more expensive pharmaceutical interventions are reimbursable. Therefore, it is financially wise not to worry until illness strikes because illness care is reimbursable, whereas preventive health care is not.
Question 3 of 5
Which conclusion can be drawn from reviewing how health care costs are spread over a person's lifetime?
Correct Answer: A
Rationale: Health care expenditures increase with age, dramatically so at older ages.
Question 4 of 5
Which best describes a current trend related to health care services?
Correct Answer: B
Rationale: There is a national shift from nonprofit health care to for-profit health care as large for-profit organizations take over smaller community organizations. Because emphasis is on profit, mechanisms of achieving higher reimbursement have been developed. Coding of the patient's illness from the CPT codes determines reimbursement. Use of computerized medical record programs almost ensures that service can be reimbursed at the highest rate possible. This has changed health care practices to the use of services that are low in cost and higher in reimbursement. High-cost services are limited or not offered.
Question 5 of 5
Which statement best describes a major event that occurred in the 1960s that affected health care?
Correct Answer: D
Rationale: The popularity and benefits of employer-provided insurance plans were recognized, as was the reality that some segments of society were being neglected. The 1960s, with a pervasive thrust for social justice, presented the opportunity to move toward universal health care coverage. Titles XVIII and XIX of the Social Security Act created Medicare and Medicaid, respectively. There was no increase in funding for training of health care providers, voluntary payment of taxes by hospitals, and an increase in the amount of charity care provided in the 1960s.