MPH Master of Public Health: Organization of Health Services & Systems 2 — Questions and Answers
Question 1: Which payment model bundles all services for a single episode of care into one fixed payment to providers?
- Fee-for-service
- Bundled payments (Correct answer)
- Capitation
- Per diem reimbursement
Correct answer: Bundled payments
Bundled payments (episode-based payments) cover all providers involved in a defined episode, incentivizing coordination and efficiency.
Question 2: The concept of 'medical home' in primary care emphasizes which of the following?
- Specialist-led acute care coordination
- Comprehensive, continuous, coordinated patient-centered care (Correct answer)
- Hospital-based outpatient services only
- Fee-for-service reimbursement structures
Correct answer: Comprehensive, continuous, coordinated patient-centered care
The patient-centered medical home model focuses on ongoing, coordinated, team-based primary care with a personal physician.
Question 3: Which federal program provides health coverage to military veterans through a network of VA hospitals and clinics?
- TRICARE
- Veterans Health Administration (VHA) (Correct answer)
- CHAMPVA
- Indian Health Service
Correct answer: Veterans Health Administration (VHA)
The Veterans Health Administration (VHA) operates the largest integrated health care system in the US, serving eligible military veterans.
Question 4: Under the Affordable Care Act, what is the purpose of an Accountable Care Organization (ACO)?
- To privatize Medicare Part D
- To coordinate care and share savings when quality benchmarks are met (Correct answer)
- To replace managed care plans entirely
- To eliminate cost-sharing for low-income patients
Correct answer: To coordinate care and share savings when quality benchmarks are met
ACOs are groups of providers that voluntarily coordinate care for Medicare patients and can share in savings if they meet quality and spending targets.
Question 5: Which health system structure places a primary care 'gatekeeper' between the patient and specialist services?
- Preferred Provider Organization (PPO)
- Health Maintenance Organization (HMO) (Correct answer)
- High-Deductible Health Plan (HDHP)
- Indemnity insurance plan
Correct answer: Health Maintenance Organization (HMO)
HMOs require members to select a primary care physician who must authorize referrals to specialists, controlling utilization and cost.
Question 6: Which measure best captures a health system's ability to provide services when patients need them without undue waiting?
- Efficiency
- Equity
- Timeliness (Correct answer)
- Effectiveness
Correct answer: Timeliness
Timeliness, one of the IOM's six quality aims, specifically addresses reducing harmful delays in receiving or providing care.
Question 7: The 'iron triangle' of health care refers to the inherent trade-off among which three dimensions?
- Access, quality, and cost (Correct answer)
- Equity, efficiency, and effectiveness
- Prevention, treatment, and rehabilitation
- Primary, secondary, and tertiary care
Correct answer: Access, quality, and cost
The iron triangle posits that improving any two of access, quality, and cost typically compromises the third, representing a fundamental health system tension.
MPH Master of Public Health: Organization of Health Services & Systems 2
Which payment model bundles all services for a single episode of care into one fixed payment to providers?