ATI RN
Economic Foundation of the US Healthcare Delivery System Questions
Question 1 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.
Question 2 of 5
Which best describes what was done by large industrial giants to stop the constant increase in their costs for health insurance for their employees?
Correct Answer: A
Rationale: Large industrial giants, such as Kaiser Permanente, decided to assemble their own health care programs. They built hospitals, hired physicians, and provided health care services to their employees. In an effort to market this concept, the phrase health maintenance organization was created. These organizations were designed to provide comprehensive care to employees. As these large health care programs were established, enrollees had limited freedom of choice. Preventive care was covered and encouraged, but care was somewhat restricted, and care providers were encouraged to reduce costs by providing only the most necessary services.
Question 3 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 4 of 5
Which statement best summarizes all of the changes resulting from attempts to control costs?
Correct Answer: A
Rationale: All these changes resulted in conflicts among providers, patients, employers, and the insurance plans, particularly when services deemed necessary by the consumer and provider were denied insurance coverage. Everyone blamed everyone else. This did not allow for costs to be controlled, impact the demand for health care, or cause employers to discontinue their insurance plans for employees.
Question 5 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.