MHA Healthcare Economics and Reimbursement 2

Question 1

Accountable Care Organizations (ACOs) under Medicare primarily aim to:

Accepted Answer

Coordinate care among providers to improve quality and reduce costs, sharing savings with CMS

Answer

ACOs are groups of providers that voluntarily coordinate care for Medicare beneficiaries; when they meet quality benchmarks and spend below target, they share in the savings with CMS.

Question 2

In a bundled payment model, reimbursement is structured as:

Accepted Answer

A single payment covering all services from multiple providers for a defined episode of care

Answer

Bundled payments provide one payment for all providers involved in a care episode (e.g., hip replacement including surgery, hospitalization, and rehab), incentivizing coordination.

Question 3

The Resource-Based Relative Value Scale (RBRVS) is used by Medicare to determine payments for:

Accepted Answer

Physician professional services

Answer

RBRVS assigns relative value units (RVUs) to physician services based on work, practice expense, and malpractice costs, forming the basis of Medicare Part B physician payment.

Question 4

Under value-based purchasing (VBP) programs, hospitals that perform poorly on quality metrics face:

Accepted Answer

A reduction in their Medicare base payment rates

Answer

CMS's Hospital Value-Based Purchasing program withholds a portion of Medicare payments and redistributes them based on quality performance, penalizing poor performers financially.

Question 5

Which metric is most commonly used to evaluate the financial health of a hospital's revenue cycle?

Accepted Answer

Days in accounts receivable (DAR)

Answer

Days in Accounts Receivable measures how long it takes a hospital to collect payment after services are rendered — lower DAR indicates a healthier, more efficient revenue cycle.

MHA - Master of Healthcare Administration Practice Test

MHA - Master of Healthcare Administration Practice Test

MHA Healthcare Economics and Reimbursement 2