ATI RN
Economic Foundation of the US Healthcare Delivery System Questions
Question 1 of 5
Which best describes how the government was successful at containing costs?
Correct Answer: D
Rationale: Prospective payment based on DRGs proved to be effective. The cost reduction that resulted gave rise to the managed care revolution as providers searched for the most cost-effective mechanism of care provision. Various efforts from, for example, certificate-of-need, peer review, and utilization review were not effective.
Question 2 of 5
Which best describes why large employers would decide to self-insure?
Correct Answer: D
Rationale: Some organizations have decided to self-insure their employees. This reduces the administrative cost of insurance. Self-insurance does not claim to offer more benefits to employees, allow for more control over health care providers, or do a better job at keeping employees happy.
Question 3 of 5
Which statement best describes why nurses should be knowledgeable about health care funding?
Correct Answer: C
Rationale: Increasing knowledge of health care funding and policy making will empower nurses to advocate for the type of funding that provides appropriate care to obtain the greatest good. Nurses need to use their political power. Nurses must advocate for health promotion disease prevention funding. Although these skills are helpful when working for insurance companies, talking to the media, and writing nurses notes, the primary reason why nurses need this knowledge is to engage in the role as a patient advocate.
Question 4 of 5
Which statements best describe what was unfortunate about the original private health insurance plans that were developed? (Select one that does not apply.)
Correct Answer: D
Rationale: The majority of the population was protected. The emphasis was placed on illness care, because providers received a fee only when a service was rendered, and all costs were reimbursed. Insulated from having to pay for health care, consumers demanded complex and technologically advanced services. These demands were a major force rapidly increasing health care costs because people with insurance felt entitled to care, and, after all, there was a guaranteed payer. Medical orientation was on curing at any cost. The profits of owning or managing an insurance company were not immediately seen.
Question 5 of 5
Which best describes what insurance companies did to decrease their constantly increasing costs? (Select one that does not apply)
Correct Answer: D
Rationale: Insurance companies attempted to reduce unnecessary use by limiting coverage for certain services and people. Restrictions such as the establishment of a gatekeeper that required preauthorization, limited coverage for preexisting illnesses, and exclusion of participants whose use was deemed exorbitant were instituted. Such restrictions increased resentment and resistance and were not very successful.