Does insuring at the firm level reduce moral hazard?
insuring at the firm level reduces the extent to which insurance has moral hazard effects. government regulation requires that employee compensation include a non-cash component and health insurance premiums qualify. it is efficient from society's perspective to link employment and health insurance coverage.
Which factor has the most pervasive influence on health care prices?
C. Both A and B D. Neither A nor B (ANSWER) In the health care marketplace, market share has the most pervasive influence on prices. FALSE; The correct answer is payer mix. A typical health care provider that increases its prices by 10% will usually realize a 10% increase in revenue.
How can a hospital increase its Medicare reimbursement?
A hospital that is caring for a Medicare patient on an inpatient basis generally can increase its reimbursement by providing additional services. A hospital that is caring for a Medicare patient on an outpatient basis generally can increase its reimbursement by providing additional services.
Why should health care managers be concerned about health care financing?
Why should health care managers be concerned about health care financing and health insurance? It's important to the organizations' bottom line and to organizational success. Who bears the costs of providing care to the uninsured? encourages the purchaser to be more aware of the cost of care.
What is the Medicare program quizlet?
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over, or who meet other special criteria.
What is a reason that healthcare costs are rising quizlet?
Three factors contribute to the rising healthcare costs; a fragmented system that multiplies administrative costs (track patient expenses and bills to multiple insurers), the power that health care providers have over consumers, and the for-profit basis of the health care system.
What is one of the reasons why Medicare costs have been rising?
The aging of the population, growth in Medicare enrollment due to the baby boom generation reaching the age of eligibility, and increases in per capita health care costs are leading to growth in overall Medicare spending.
Which of the following is not an essential health benefit category under the Affordable Care Act quizlet?
Which of the following is NOT an essential health benefit found in qualified health plans? Qualified health plans (QHPs) must offer essential health benefits such as emergency, rehabilitative and pediatric services. Dental services are not included in the list of essential health benefits.
What is the primary cause of rising medical costs in the United States?
Five factors contribute to the rise in health care costs in the US: (1) more people; (2) an aging population; (3) changes in disease prevalence or incidence; (4) increases in how often people use health care services; and (5) increases in the price and intensity of services.
What is the greatest problem of Medicare quizlet?
Unrestrained malpractice awards by the courts and increased malpractice insurance premiums for physicians significantly add to the cost of health care. been identified as a major problem in the Medicare and Medicaid programs. Fraud occurs when billing claims or cost reports are intentionally falsified.
What are the three factors due to which health care costs keep rising?
Reasons for Rising Costs of Healthcare Scarcity of experts who are qualified to use advanced medical equipment and robotics. Patients opting for higher category hospital rooms and extended hospital stay, depending on the health condition of the patient. Shortage of specialist doctors and surgeons in a particular field.
Which of the following is a major reason why the Medicare program is in such financial trouble?
Which of the following is a major reason why the Medicare program is in such financial trouble? Because medical services are subsidized by the government, both consumption by the elderly and the cost of services have increased.
Which of the following is a major cause for the dramatic increase in healthcare costs in the United States since 1980?
insurance costsBut the main driver of the increase is not drug costs or medical services. In fact, the costs related to medical services have decreased by about a third since the 1980s. The biggest reason for the increase is insurance costs, which have grown by 740% since 1984, Clever calculates.
What is not covered under the Affordable Care Act?
Long-term care: You will need to pay for long-term care if you become disabled or need to move to a nursing home. It's not an essential health benefit under the Affordable Care Act and is not covered by Medicare or most private health plans. Abortion: Abortion is not one of the essential health benefits.
Which of the following provisions of the Patient Protection and Affordable Care Act is not true?
Which of the following is NOT true regarding the Affordable Care Act? It does not enact a guaranteed-issue requirement that prohibits insurance companies from denying coverage to those with preexisting conditions.
Which of the following is a benefit of the Affordable Care Act quizlet?
Increases benefits and lower costs for consumers, bolster our health care and public health workforce and infrastructure, foster innovation and quality in our system. Covers preventative care at no cost to you, protects your choice of doctors, removes insurance company barriers to emergency services.
What is the minimum eligibility factor for Medicaid?
Response Feedback: Medicaid eligibility must meet a variety of conditions and allow for variances from state to state, however, the minimum eligibility factor that all Medicaid programs have in common is the federal poverty level (FPL) which is a pre-determined annual income amount for a family of four.
How long does it take to file a Medicare claim?
Medicaid claims must be filed: a. within 95 days. b. within 365 days. c. based on the individual state's timely filing requirement. d. within 180 days.
How long does it take to file a claim for tricare?
TRICARE and CHAMPVA both have a one-year timely filing limit. There are exceptions allowed for retroactive benefit issues, when the time frame for filing goes back to your eligibility date. In those cases, once notified, 180 days are allowed to submit a claim.
How does Medicare increase?
It increases as more is spent on health care. It first decreases and then increases as more is spent on health care. It first increases and then decreases as more is spent on health care. It decreases as more is spent on health care. It decreases as more is spent on health care. Medicare is financed by:
What is expanded Medicaid?
replaced Medicaid with private insurance for all eligible individuals. expanded Medicaid's medical coverage of children to include prescription drugs. mandated that the states ensure that every child is covered by health insurance.
Do all workers have to participate in group insurance?
All workers are required to participate in the group insurance plan. Workers take into account their health status when choosing which firm to work for. Workers do not take into account their health status when choosing which firm to work for. The firm employs a large group of people.