MPH Master of Public Health: Public Health & U.S. Health Care 4 — Questions and Answers
Question 1: The Medicaid program in the United States is jointly funded by:
- Federal government and state governments (Correct answer)
- State governments and county governments only
- Federal government and private insurers
- Employer contributions and federal government
Correct answer: Federal government and state governments
Medicaid is a federal-state partnership where both levels of government contribute funding, with states administering their own programs within federal guidelines.
Question 2: Which of the following is the BEST example of a 'population-based' public health intervention?
- Prescribing statins to a patient with high cholesterol
- Adding fluoride to community water supplies to prevent tooth decay (Correct answer)
- Performing colonoscopy screening on an individual patient
- Providing insulin therapy to a diabetic patient
Correct answer: Adding fluoride to community water supplies to prevent tooth decay
Water fluoridation targets an entire community population rather than individual patients, exemplifying a population-based approach to prevention.
Question 3: In the context of U.S. health care quality measurement, HEDIS (Healthcare Effectiveness Data and Information Set) is used primarily to:
- Set Medicare reimbursement rates for hospitals
- Measure performance of health plans across dimensions of care and service (Correct answer)
- Accredit individual physicians and clinicians
- Calculate insurance premiums for employer-sponsored plans
Correct answer: Measure performance of health plans across dimensions of care and service
HEDIS, maintained by NCQA, is a tool used by health plans to measure performance on dimensions such as preventive care, chronic disease management, and patient experience.
Question 4: Which concept describes the proportion of the population that must be immune to a disease to prevent sustained transmission in the community?
- Attack rate
- Herd immunity threshold (Correct answer)
- Case fatality rate
- Secondary attack rate
Correct answer: Herd immunity threshold
The herd immunity threshold is the minimum proportion of immune individuals needed to stop self-sustaining disease transmission within a population.
Question 5: The 'Children's Health Insurance Program' (CHIP) was created to provide health coverage for:
- Children in foster care only
- Children in families with incomes too high for Medicaid but who cannot afford private insurance (Correct answer)
- All children under age 6 regardless of family income
- Children of federal government employees
Correct answer: Children in families with incomes too high for Medicaid but who cannot afford private insurance
CHIP covers children in families whose incomes are above Medicaid thresholds but who would otherwise be uninsured due to the cost of private coverage.
Question 6: Which of the following represents a 'structural determinant' of health disparities, as opposed to an individual behavioral factor?
- A patient's decision to smoke cigarettes
- Residential segregation that concentrates poverty in certain neighborhoods (Correct answer)
- An individual's choice to eat an unhealthy diet
- A person's level of physical activity
Correct answer: Residential segregation that concentrates poverty in certain neighborhoods
Structural determinants like residential segregation are systemic, policy-driven conditions that shape the environments in which individuals make health-related decisions.
Question 7: Which of the following is a key feature that distinguishes a 'preferred provider organization' (PPO) from an HMO?
- PPOs require a primary care physician gatekeeper for all specialist visits
- PPOs allow members to see out-of-network providers at a higher cost without referrals (Correct answer)
- PPOs provide coverage only within a fixed network with no out-of-network benefit
- PPOs are exclusively government-funded programs
Correct answer: PPOs allow members to see out-of-network providers at a higher cost without referrals
PPOs offer more flexibility by allowing members to use out-of-network providers, though at a higher cost, and do not require referrals for specialist care.
MPH Master of Public Health: Public Health & U.S. Health Care 4
The Medicaid program in the United States is jointly funded by: