ATI RN
Future Economic Needs of the US Healthcare System Questions
Question 1 of 5
Which best describes how the federal government determines which projects are awarded special funding for health care?
Correct Answer: A
Rationale: Allocation of federal resources is based on societal priorities, such as Healthy People 2020. Legislative priority, priority within health care organizations, and priority within individual states are not as important for federal funding as the societal priorities outlined in Healthy People 2020.
Question 2 of 5
Which best describes what physicians did to compete with new competition from health maintenance organizations (HMOs)?
Correct Answer: B
Rationale: In an effort to compete with HMOs, physicians and hospitals organized the independent practice model, which provided services to enrollees of one insurance company. This model evolved into the PPO, which offered services at a reduced rate in exchange for a guaranteed increase in consumers. Physicians did not become directly employed by insurance companies, set up private practices with colleagues, or decide to strike in order to compete with the HMOs.
Question 3 of 5
Which best describes how hospitals initially coped when Medicare reimbursement became based on diagnosis-related groups (DRGs)?
Correct Answer: A
Rationale: Hospitals developed cost shifting to supplement losses caused by Medicare funding. Because private insurance reimbursements were cost based, hospitals included the loss in their total costs; therefore private insurance paid for covering care to both their enrollees and Medicare patients. The implementation of DRGs did not cause hospitals to decrease nursing staff, lobby politicians to increase Medicare reimbursement, or refuse to accept Medicare patients.
Question 4 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 5 of 5
When was the idea of national health care insurance first debated in the United States?
Correct Answer: D
Rationale: European countries began a social model of health insurance in the early 1900s. President Theodore Roosevelt advocated a similar plan for the United States in 1916. The other attempts mentioned came after Theodore Roosevelt's initial attempt in 1916.