MPH Health Policy & Management

Question 1

What does 'utilization review' mean in U.S. health care management?

Accepted Answer

Evaluating the appropriateness and necessity of health care services

Answer

Tracking patient satisfaction scores

Answer

Auditing hospital billing codes

Answer

Monitoring staff performance and productivity

Question 2

The Affordable Care Act (ACA) introduced which key mechanism to expand coverage?

Accepted Answer

Insurance marketplaces and Medicaid expansion

Answer

A single-payer national health insurance system

Answer

Mandatory employer-sponsored insurance for all companies

Answer

Medicare for individuals under age 65

Question 3

A 'capitation' payment model means:

Accepted Answer

Providers receive a fixed payment per patient per period, regardless of services used

Answer

Providers are paid per service rendered

Answer

Patients pay a flat annual premium directly to providers

Answer

Payments are based on outcomes achieved

Question 4

Which type of managed care organization (MCO) requires members to use network providers and obtain referrals from a primary care physician?

Accepted Answer

Health Maintenance Organization (HMO)

Answer

Preferred Provider Organization (PPO)

Answer

Point-of-Service (POS) plan

Answer

High-Deductible Health Plan (HDHP)

Question 5

The term 'moral hazard' in health economics refers to:

Accepted Answer

The tendency to use more health services when insured because the individual doesn't bear full costs

Answer

Unethical billing practices by providers

Answer

The risk of adverse selection in insurance markets

Answer

Conflicts of interest in health policy decision-making

Question 6

A SWOT analysis in health management examines:

Accepted Answer

Strengths, Weaknesses, Opportunities, and Threats

Answer

Staff, Workload, Operations, and Training

Answer

Systems, Workflows, Outcomes, and Targets

Answer

Surveys, Waivers, Oversight, and Transparency