MPH Master of Public Health: Organization of Health Services & Systems 3 — Questions and Answers
Question 1: Which regulatory mechanism requires hospitals to obtain state approval before adding expensive new services or equipment?
- Certificate of Need (CON) laws (Correct answer)
- Stark Law
- Anti-Kickback Statute
- Hill-Burton Act requirements
Correct answer: Certificate of Need (CON) laws
CON laws require health care facilities to demonstrate community need and receive state approval before expanding capacity or purchasing major equipment.
Question 2: In the context of health systems, 'horizontal integration' refers to:
- Merging hospitals with the same level of care (Correct answer)
- A hospital acquiring physician practices and home health agencies
- Combining acute care with long-term care services
- Integrating mental health into primary care settings
Correct answer: Merging hospitals with the same level of care
Horizontal integration occurs when organizations at the same level of the care continuum merge, such as two hospitals or multiple clinics forming a network.
Question 3: Which financing concept describes a situation where individuals without insurance use emergency departments for non-emergency primary care?
- Moral hazard
- Adverse selection
- Cost shifting (Correct answer)
- Free riding
Correct answer: Cost shifting
Cost shifting occurs when uncompensated care costs incurred by uninsured patients are offset by charging higher prices to insured patients or payers.
Question 4: The Donabedian model evaluates health care quality along which three dimensions?
- Inputs, processes, outcomes
- Structure, process, outcomes (Correct answer)
- Access, utilization, outcomes
- Efficiency, equity, effectiveness
Correct answer: Structure, process, outcomes
Avedis Donabedian proposed evaluating quality through structure (resources and settings), process (what is done), and outcomes (effects on health).
Question 5: Which federal law mandates that hospitals provide emergency stabilizing treatment regardless of a patient's ability to pay?
- HIPAA
- EMTALA (Correct answer)
- ACA
- COBRA
Correct answer: EMTALA
The Emergency Medical Treatment and Labor Act (EMTALA) prohibits hospitals with emergency departments from refusing emergency care based on insurance status or ability to pay.
Question 6: A health system that serves as both the insurer and the provider of care is best described as:
- A preferred provider organization
- An integrated delivery system with staff-model HMO characteristics (Correct answer)
- An indemnity plan with direct contracting
- A self-insured employer plan
Correct answer: An integrated delivery system with staff-model HMO characteristics
Staff-model HMOs and Kaiser Permanente-style integrated systems combine insurance functions and direct care delivery under one organizational umbrella.
Question 7: Which concept describes the tendency for people with higher health risks to disproportionately seek health insurance coverage?
- Moral hazard
- Adverse selection (Correct answer)
- Risk pooling
- Cream skimming
Correct answer: Adverse selection
Adverse selection occurs when individuals with greater expected health needs are more likely to enroll in insurance, skewing the risk pool and increasing premiums.
MPH Master of Public Health: Organization of Health Services & Systems 3
Which regulatory mechanism requires hospitals to obtain state approval before adding expensive new services or equipment?