MHA Trivia 3 — Questions and Answers
Question 1: What does the term 'capitation' mean in managed care contracting?
- A fixed monthly payment per enrolled member regardless of services used (Correct answer)
- A fee charged per hospital admission
- A penalty imposed for readmissions within 30 days
- A percentage-based payment for each procedure performed
Correct answer: A fixed monthly payment per enrolled member regardless of services used
Capitation is a payment model where providers receive a set per-member-per-month fee, shifting financial risk from payers to providers.
Question 2: Which healthcare quality framework uses the dimensions of safe, effective, patient-centered, timely, efficient, and equitable care?
- Institute of Medicine's (IOM) Six Aims (Correct answer)
- Donabedian's Structure-Process-Outcome Model
- Baldrige Performance Excellence Framework
- Triple Aim Framework
Correct answer: Institute of Medicine's (IOM) Six Aims
The IOM's landmark 2001 report 'Crossing the Quality Chasm' introduced six aims for improving healthcare quality in the US.
Question 3: The 'Hill-Burton Act' of 1946 was significant to healthcare administration because it:
- Provided federal funding for hospital construction and required free care for some patients (Correct answer)
- Established Medicare and Medicaid programs
- Mandated employer-sponsored health insurance
- Created the first national nursing licensing standards
Correct answer: Provided federal funding for hospital construction and required free care for some patients
The Hill-Burton Act provided grants and loans for hospital construction and modernization, with the requirement that facilities provide some free or reduced-cost care.
Question 4: In healthcare operations, what is a 'critical pathway' (also called a clinical pathway)?
- A standardized care plan outlining expected treatments and timelines for a specific diagnosis (Correct answer)
- An emergency evacuation route within a hospital
- A priority list for ICU bed allocation
- A regulatory compliance checklist for accreditation surveys
Correct answer: A standardized care plan outlining expected treatments and timelines for a specific diagnosis
Clinical pathways are evidence-based, multidisciplinary care plans that standardize care processes for specific diagnoses to improve outcomes and efficiency.
Question 5: Which federal legislation requires hospitals to provide emergency care to anyone regardless of their ability to pay?
- Emergency Medical Treatment and Labor Act (EMTALA) (Correct answer)
- Hill-Burton Act
- Consolidated Omnibus Budget Reconciliation Act (COBRA)
- Medicare Access and CHIP Reauthorization Act (MACRA)
Correct answer: Emergency Medical Treatment and Labor Act (EMTALA)
EMTALA, enacted in 1986, requires hospitals with emergency departments to provide a medical screening exam and stabilizing treatment regardless of a patient's ability to pay.
Question 6: What is the primary role of a Chief Medical Officer (CMO) in a hospital setting?
- To serve as the senior physician leader overseeing clinical quality and medical staff affairs (Correct answer)
- To manage the hospital's financial performance and budget
- To oversee marketing and patient acquisition strategies
- To coordinate supply chain and materials management
Correct answer: To serve as the senior physician leader overseeing clinical quality and medical staff affairs
The CMO is the top physician executive responsible for clinical quality, patient safety, medical staff credentialing, and physician relations within the hospital.
Question 7: In healthcare statistics, what does 'morbidity' measure?
- The incidence or prevalence of disease in a population (Correct answer)
- The death rate within a specific population
- The financial cost of treating illness
- Patient satisfaction with their care experience
Correct answer: The incidence or prevalence of disease in a population
Morbidity refers to the state of being diseased or unhealthy, measured by the rate of illness or disease incidence and prevalence in a given population.
MHA Trivia 3
What does the term 'capitation' mean in managed care contracting?