#1
Which of the following is a characteristic of a single-payer healthcare system?
Healthcare is provided and financed by the government.
ExplanationUniversal coverage and government-funded healthcare.
#2
What does the term 'co-payment' refer to in health insurance?
A fixed amount the insured must pay for each medical service
ExplanationFixed payment per medical service.
#3
Which of the following is not a type of managed care organization (MCO)?
Consumer Directed Health Plan (CDHP)
ExplanationCDHP is not a managed care organization.
#4
What is the purpose of Medicaid in the United States?
To provide healthcare coverage to low-income individuals and families
ExplanationHealth coverage for low-income individuals.
#5
What is the purpose of the Health Insurance Portability and Accountability Act (HIPAA) in the United States?
To protect individuals' health information privacy and security
ExplanationPrivacy and security of health information.
#6
Which of the following is a characteristic of a fee-for-service healthcare payment model?
Providers are paid based on the number of services performed
ExplanationPayment based on service quantity.
#7
What is the role of a healthcare utilization review?
To review medical records to ensure appropriate use of healthcare resources
ExplanationEvaluating healthcare resource usage.
#8
Which of the following is NOT a factor contributing to rising healthcare costs?
Decrease in the prevalence of chronic diseases
ExplanationDecline in chronic diseases doesn't raise costs.
#9
In insurance, what does the term 'adverse selection' refer to?
When individuals who are likely to incur high medical expenses are more likely to purchase insurance
ExplanationHigh-risk individuals favoring insurance.
#10
What is the purpose of a health savings account (HSA)?
To allow individuals to save money tax-free for medical expenses
ExplanationTax-free savings for medical costs.
#11
Which of the following statements best describes a high-deductible health plan (HDHP)?
It has high out-of-pocket costs and low monthly premiums
ExplanationHigh costs, low premiums.
#12
Which of the following statements best describes a health maintenance organization (HMO)?
It requires a referral to see a specialist.
ExplanationSpecialist visits require referrals.
#13
Which of the following is a characteristic of a preferred provider organization (PPO)?
It offers discounted rates for in-network providers.
ExplanationDiscounted rates within network.
#14
What is the role of a health insurance underwriter?
To assess risk and determine premium rates
ExplanationEvaluating risk and setting premiums.