MPH Master of Public Health: Organization of Health Services & Systems 4 — Questions and Answers
Question 1: Which global health system typology, developed by Victor Fuchs and others, describes a system where the government both finances and delivers all health care?
- Bismarck model
- Beveridge model (Correct answer)
- National health insurance model
- Out-of-pocket model
Correct answer: Beveridge model
The Beveridge model, exemplified by the UK's NHS, has the government collect taxes, own facilities, and employ providers to deliver universal coverage.
Question 2: In the US, which government program specifically targets low-income children whose families earn too much for Medicaid?
- Medicare Part C
- Children's Health Insurance Program (CHIP) (Correct answer)
- Title V Maternal and Child Health
- SNAP health benefit
Correct answer: Children's Health Insurance Program (CHIP)
CHIP covers uninsured children in families with incomes above Medicaid eligibility limits but too low to afford private insurance, funded jointly by federal and state governments.
Question 3: The 'inverse care law,' proposed by Julian Tudor Hart, states that:
- Preventive care investments produce diminishing returns over time
- The availability of good medical care tends to vary inversely with need (Correct answer)
- Tertiary care spending crowds out primary care investment
- Insurance coverage expands as population health improves
Correct answer: The availability of good medical care tends to vary inversely with need
The inverse care law observes that communities with the greatest health needs typically have the poorest access to quality medical care.
Question 4: Which organizational structure allows multiple independent physician practices to negotiate collectively with insurers while remaining legally separate?
- Group practice without walls (GPWW)
- Independent Practice Association (IPA) (Correct answer)
- Physician-hospital organization (PHO)
- Multi-specialty group practice
Correct answer: Independent Practice Association (IPA)
An IPA is a legal entity of independent physicians who contract together with managed care organizations while maintaining their separate practices.
Question 5: Which quality improvement framework uses Define, Measure, Analyze, Improve, and Control (DMAIC) phases?
- Lean methodology
- Six Sigma (Correct answer)
- Plan-Do-Study-Act (PDSA)
- Root cause analysis
Correct answer: Six Sigma
Six Sigma uses the DMAIC framework to identify and eliminate defects in processes, aiming for no more than 3.4 defects per million opportunities.
Question 6: The Hill-Burton Act of 1946 primarily aimed to:
- Establish Medicare and Medicaid funding formulas
- Fund hospital construction in underserved areas (Correct answer)
- Create the Veterans Health Administration
- Regulate hospital merger and acquisition activity
Correct answer: Fund hospital construction in underserved areas
The Hill-Burton Act provided federal grants for hospital construction and modernization in exchange for obligations to provide free or reduced-cost care to those unable to pay.
Question 7: Which term describes the financial risk borne by a managed care plan when actual health care costs exceed capitated premium revenue?
- Underwriting risk (Correct answer)
- Reinsurance exposure
- Actuarial deficit
- Insolvency trigger
Correct answer: Underwriting risk
Underwriting risk is the possibility that claims exceed premiums collected, requiring the insurer to pay out more than it took in, potentially causing financial losses.
MPH Master of Public Health: Organization of Health Services & Systems 4
Which global health system typology, developed by Victor Fuchs and others, describes a system where the government both finances and delivers all health care?