CPE Healthcare System and Policy 2

Question 1

Under the ACA's Medicaid expansion, states that opted in extended eligibility to adults with incomes up to what percentage of the federal poverty level?

Accepted Answer

133%

Answer

The ACA expanded Medicaid to non-elderly adults with incomes up to 133% FPL (effectively 138% with the 5% income disregard).

Question 2

Which federal program provides health insurance primarily to individuals with disabilities and end-stage renal disease, regardless of age?

Accepted Answer

Medicare

Answer

Medicare covers people with qualifying disabilities and end-stage renal disease in addition to those aged 65 and older.

Question 3

The concept of 'never events' in healthcare policy refers to which of the following?

Accepted Answer

Serious preventable adverse events that should never occur

Answer

Never events are serious, largely preventable patient safety incidents (e.g., wrong-site surgery) that CMS will not reimburse.

Question 4

A hospital's case mix index (CMI) reflects which of the following?

Accepted Answer

The average acuity and resource intensity of its patient population

Answer

CMI measures the relative weight of Medicare DRGs for a hospital's inpatient cases, indicating acuity and expected resource use.

Question 5

Which legislation established the Hospital Readmissions Reduction Program (HRRP) that penalizes hospitals for excess readmissions?

Accepted Answer

The Affordable Care Act

Answer

The ACA created the HRRP, which reduces Medicare payments to hospitals with higher-than-expected 30-day readmission rates for targeted conditions.

(CPE) Certified Physician Executive Practice Test

(CPE) Certified Physician Executive Practice Test

CPE Healthcare System and Policy 2