MPH Master of Public Health: Organization of Health Services & Systems 5 — Questions and Answers
Question 1: Which health system performance framework, used by the Commonwealth Fund, evaluates countries across care process, access, administrative efficiency, equity, and health care outcomes?
- WHO Health System Framework
- Mirror, Mirror comparative scorecard (Correct answer)
- OECD Health Statistics Index
- Global Burden of Disease ranking
Correct answer: Mirror, Mirror comparative scorecard
The Commonwealth Fund's Mirror, Mirror report compares high-income country health systems on five performance domains to identify best practices and gaps.
Question 2: What does 'scope of practice' regulation primarily determine in health services delivery?
- How much a provider can charge for services
- Which services a licensed health professional is legally authorized to perform (Correct answer)
- The geographic area in which a provider may practice
- Minimum quality standards for hospital accreditation
Correct answer: Which services a licensed health professional is legally authorized to perform
Scope of practice laws, determined at the state level, define the procedures, actions, and processes permitted for each category of licensed health professional.
Question 3: A public health department implementing a program to reduce hospital readmissions for heart failure patients is primarily operating at which level of prevention?
- Primary prevention
- Secondary prevention
- Tertiary prevention (Correct answer)
- Primordial prevention
Correct answer: Tertiary prevention
Tertiary prevention focuses on managing established disease to prevent complications, deterioration, and disability — including reducing avoidable readmissions.
Question 4: Which concept explains why a fixed-payment capitation system may incentivize providers to select healthier patients?
- Adverse selection
- Cream skimming (favorable risk selection) (Correct answer)
- Moral hazard
- Principal-agent problem
Correct answer: Cream skimming (favorable risk selection)
Cream skimming occurs when providers or plans preferentially enroll healthier individuals to maximize profit under fixed-payment arrangements, leaving sicker patients underserved.
Question 5: The US Drug Enforcement Administration (DEA) Schedule of controlled substances primarily affects health system organization by:
- Setting maximum out-of-pocket costs for prescriptions
- Regulating how providers prescribe and dispense controlled medications (Correct answer)
- Determining which drugs Medicare Part D must cover
- Licensing pharmacy benefit managers
Correct answer: Regulating how providers prescribe and dispense controlled medications
DEA scheduling determines legal requirements for prescribing, dispensing, storage, and record-keeping of controlled substances, directly shaping clinical workflows.
Question 6: Which component of the Affordable Care Act was designed to create competition among private insurers for individuals and small businesses?
- Medicaid expansion
- Health Insurance Marketplaces (Exchanges) (Correct answer)
- Individual shared responsibility provision
- Essential health benefits mandate
Correct answer: Health Insurance Marketplaces (Exchanges)
ACA Marketplaces (Exchanges) are regulated online platforms where individuals and small employers can compare and purchase standardized insurance plans, often with subsidies.
Question 7: In health systems research, 'population health management' is best distinguished from traditional clinical care by its focus on:
- Treating individual patients at the point of highest acuity
- Proactively identifying and addressing health needs across a defined population (Correct answer)
- Maximizing specialist utilization within a hospital system
- Standardizing treatment protocols for common diagnoses
Correct answer: Proactively identifying and addressing health needs across a defined population
Population health management uses data-driven strategies to identify at-risk individuals, stratify populations, and intervene proactively before acute episodes occur.
MPH Master of Public Health: Organization of Health Services & Systems 5
Which health system performance framework, used by the Commonwealth Fund, evaluates countries across care process, access, administrative efficiency, equity, and health care outcomes?