ATI RN
Future Economic Needs of the US Healthcare System Questions
Question 1 of 5
Which best describes how providers can legally improve their profit under the current reimbursement process?
Correct Answer: D
Rationale: As a reward for conservative medical practices, health care providers may receive a specified amount of money or a percentage of the agreed reimbursement if services are delivered below the limit set by the third-party payer. Thus, it is the responsibility of the provider to use this conservative practice. Patient care should not be compromised as providers practice conservatively.
Question 2 of 5
Which best describes a carve-out service?
Correct Answer: A
Rationale: Carve-out services might be designated for those who need the services the least. A carve-out service (e.g., mental health care) is provided within a standard benefit package but delivered exclusively by a designated provider or group. The other definitions do not correctly describe a carve-out service.
Question 3 of 5
Which best describes the effects of Medicare and Medicaid? (Select one that does not apply)
Correct Answer: A
Rationale: The enactment of Medicare and Medicaid created an unprecedented demand for services, and many persons without access to health care were now able to receive care using an indemnity insurance plan. Medicare reimbursement rates generally became the standard for all insurance carriers. These plans did not provide services for the temporarily disabled or change financing for public health education.
Question 4 of 5
Which best describes the strengths of the American health care system? (Select all that apply.)
Correct Answer: A
Rationale: The United States leads the world in laboratory and clinical research. The United States also exceeds other industrialized countries in the availability and use of technological advances. We do not rank near the top in length of life or patient care outcomes although we spend far more on health care than other industrialized nations. We are just beginning to confront the issues of access and rationing.
Question 5 of 5
Which best describes how eligibility for Medicaid services is determined? (Select one that does not apply.)
Correct Answer: A
Rationale: Medicaid provides universal health care coverage for the indigent and children. Eligibility is dependent on the size and income of the family. The federal government sets baseline eligibility requirements. State governments who wish to provide care to more citizens can lower the eligibility requirements. The federal government mandates covered services, but state governments may provide more services.