ABPS Healthcare Systems & Administration 2

Question 1

Which federal agency oversees the Medicare and Medicaid programs in the United States?

Accepted Answer

Centers for Medicare & Medicaid Services (CMS)

Answer

CMS, a federal agency within DHHS, administers Medicare, Medicaid, CHIP, and other health-related programs.

Question 2

A hospital's 'case mix index' (CMI) is primarily used to measure which of the following?

Accepted Answer

The complexity and resource intensity of patient cases

Answer

CMI reflects the average clinical complexity and resource use of inpatient cases, influencing hospital reimbursement and resource planning.

Question 3

Under EMTALA, what is a hospital's obligation when a patient presents to the emergency department?

Accepted Answer

Screen and stabilize any patient regardless of ability to pay

Answer

EMTALA requires hospitals to provide a medical screening exam and necessary stabilizing treatment to all emergency patients regardless of insurance or financial status.

Question 4

Which payment model reimburses a fixed amount per patient per month regardless of services used?

Accepted Answer

Capitation

Answer

Capitation is a payment arrangement where a provider receives a set amount per enrolled patient per month, incentivizing cost-efficient preventive care.

Question 5

What does the term 'credentialing' refer to in a hospital setting?

Accepted Answer

Verifying a physician's education, training, licensure, and competence before granting privileges

Answer

Credentialing is the process of verifying a provider's qualifications and granting clinical privileges to practice within a healthcare institution.

(ABPS) American Board of Physician Specialties Certification Practice Test

(ABPS) American Board of Physician Specialties Certification Practice Test

ABPS Healthcare Systems & Administration 2