Healthcare Policy and Economics (D223)

Correct Answer

C. Provide more quantities of care and/or see more patients

Explanation

Studies have indicated that physicians compensated under an incentive-based system tend to provide more care and see more patients. This system is designed to reward physicians for meeting certain performance targets, such as the number of patients seen or services provided, which can lead to an increase in patient volume and care quantity. However, this can sometimes result in concerns about quality of care due to the focus on quantity.

Why other options are wrong

A. Provide less quantities of care and/or see less patients

This is incorrect because incentive-based compensation tends to drive physicians to see more patients and provide more services in order to meet the targets set for their compensation, rather than providing fewer services.

B. Provide lower quality care

This is incorrect because while incentive-based systems may encourage physicians to see more patients, it doesn't inherently mean the quality of care decreases. However, there can be concerns that a focus on quantity might indirectly affect the quality of care, but the statement itself is not universally true.

D. Provide no difference in quantities of care and/or number of patients

This is incorrect because studies suggest that there is a noticeable difference in the number of patients seen and the quantity of care provided under incentive-based systems, as physicians may be motivated to meet performance goals.

Correct Answer

D. Salaries offer less 'wiggle room' and do not necessarily compensate providers for working extra hours/shifts.

Explanation

One argument against paying physicians a salary instead of fee-for-service is that salaried arrangements often do not compensate providers for extra hours or shifts worked. With fee-for-service, physicians are incentivized to see more patients or perform additional services to increase their earnings. Salaries may offer financial stability but lack this incentive, which can lead to dissatisfaction for physicians who work beyond standard hours.

Why other options are wrong

A. Salaries still encourage providers to recommend unnecessary tests and procedures.

This is a concern associated with fee-for-service models, not salaried models. In fee-for-service, providers are paid based on the volume of services rendered, which might lead to unnecessary tests. However, salaried physicians are typically less incentivized by volume-based payments.

B. Salaries discourage providers from considering the costs of the treatments they recommend.

Salaries do not inherently discourage providers from considering costs. In fact, salaried arrangements can encourage more thoughtful and cost-effective decision-making, as physicians are not directly compensated for more treatments or tests.

C. Salaries provide less relative financial stability.

Salaries generally offer more financial stability than fee-for-service arrangements, as physicians receive consistent pay, irrespective of the number of patients they see. This option is incorrect because salaried positions are typically viewed as providing greater stability.

Correct Answer

D. Through tax revenues and government funding

Explanation

Governmental healthcare organizations are funded primarily through public tax revenues and government funding. These organizations are usually operated by the government at local, state, or federal levels and are financed by taxpayer money, which supports their services to the public. This method ensures that healthcare services remain accessible to all, regardless of individuals' ability to pay.

Why other options are wrong

A. Through insurance premiums collected from patients

This option is incorrect because governmental healthcare organizations typically do not rely on insurance premiums paid by patients for their funding. Instead, they are funded through taxes and government allocations. Insurance premiums are generally associated with private healthcare systems or specific programs like Medicaid or Medicare, not the primary funding mechanism for government-run health services.

B. By charging high fees for services rendered

This is incorrect because governmental healthcare organizations are designed to provide affordable care to the public, which typically includes services subsidized by tax dollars. Charging high fees would contradict the purpose of these organizations, which aim to ensure healthcare accessibility for everyone, including lower-income individuals.

C. Through private donations and fundraising events

While some governmental healthcare organizations may accept private donations, this is not their primary funding source. Donations and fundraising events may supplement government funding but cannot sustain the operational costs of such organizations. The bulk of the funding comes from tax revenues and government grants, not private contributions.

Correct Answer

B. Heightened demands for evidence supporting the effectiveness of utilization controls

Explanation

The scrutiny surrounding utilization controls led to a greater focus on evaluating the effectiveness of these controls in managing costs while maintaining quality of care. Stakeholders, including policymakers and insurers, demanded evidence that utilization controls actually improved care quality or reduced unnecessary treatments, leading to more research and data-driven approaches to healthcare management.

Why other options are wrong

A. Increased funding for preventive care programs

While preventive care is important in healthcare, increased funding for such programs was not a direct consequence of scrutiny surrounding utilization controls. The scrutiny focused more on the management of care rather than direct funding for prevention.

C. Reduction in the number of healthcare providers

This is incorrect as the scrutiny did not necessarily lead to a reduction in the number of healthcare providers. Utilization controls were primarily aimed at managing the cost of care, not reducing provider numbers.

D. Expansion of fee-for-service models

This is incorrect. The scrutiny surrounding utilization controls actually highlighted the limitations of fee-for-service models, leading to an interest in alternative models such as capitation or value-based care that focus more on outcomes and efficiency rather than volume of services.

Correct Answer

A. Lack of time, resources, and support.

Explanation

A significant barrier to nurses' engagement in policy change is the lack of time, resources, and support. Nurses often have demanding clinical responsibilities, and without proper time allocation or organizational backing, it can be difficult for them to participate in policy change initiatives. Adequate resources and institutional support are essential to allow nurses to engage in meaningful policy development and advocacy.

Why other options are wrong

B. Overwhelming support from healthcare organizations

While support from healthcare organizations is crucial, it is not a barrier. The lack of support or insufficient engagement from organizations is a barrier, not overwhelming support. Nurses need organizational backing to participate effectively in policy change.

C. Excessive funding for policy training

Excessive funding for policy training is not typically a barrier. In fact, additional funding for training programs can help nurses become more involved in policy discussions. The issue is usually a lack of funding or opportunities for education in policy matters, rather than an excess of it.

D. Abundant public relations skills among nurses

While public relations skills may be helpful for nurses in advocating for policy changes, the abundance of such skills is not a barrier. The true barrier lies in practical issues like time, resources, and institutional support, rather than nurses’ abilities to engage in public relations.

Correct Answer

D. has grown more rapidly than any other sector of the economy

Explanation

Over the past several years, U.S. healthcare spending has continued to increase at a faster rate than other sectors of the economy. The growth in healthcare spending has been driven by factors such as an aging population, increased prevalence of chronic conditions, advances in medical technology, and rising healthcare prices. This trend has outpaced the growth of many other economic sectors.

Why other options are wrong

A. leveled off

This is incorrect. Healthcare spending has not leveled off in recent years; it has continued to increase at a higher rate than other sectors.

B. fallen as a percent of the GDP

This is incorrect. Healthcare spending has not fallen as a percentage of GDP. In fact, it has continued to increase and now represents a significant portion of the U.S. GDP.

C. has been surpassed only by escalating housing costs

This is incorrect. While housing costs have increased, healthcare spending has still grown more rapidly than housing costs, making it one of the fastest-growing sectors in the U.S. economy.

Correct Answer

A. Healthcare as a commodity prioritizes market efficiency, while healthcare as a right emphasizes equitable access for all individuals.

Explanation

Viewing healthcare as a commodity places emphasis on market principles, where healthcare is treated as a product subject to supply and demand, and market efficiency is prioritized. On the other hand, viewing healthcare as a right stresses the importance of ensuring equitable access to healthcare for all individuals, regardless of their ability to pay.

Why other options are wrong

B. Healthcare as a commodity focuses on universal coverage, while healthcare as a right limits access based on income.

This is incorrect because healthcare as a commodity does not necessarily focus on universal coverage. It is more focused on efficiency and market-based mechanisms, whereas healthcare as a right aims to provide equal access to all individuals, irrespective of their income.

C. Healthcare as a commodity advocates for government control, while healthcare as a right supports privatization.

This is inaccurate because healthcare as a commodity often supports privatization and market-driven approaches, whereas healthcare as a right tends to advocate for more government intervention or oversight to ensure that all individuals can access care.

D. Healthcare as a commodity is based on social justice principles, while healthcare as a right is driven by profit motives.

This statement is reversed. Healthcare as a commodity is typically driven by profit motives and market principles, while healthcare as a right aligns more with social justice principles, emphasizing access for all.

Correct Answer

B. Through patient payments and insurance reimbursements.

Explanation

Private healthcare organizations primarily rely on payments from patients and reimbursements from insurance companies to fund their operations. This model allows them to generate the revenue needed to provide medical services, maintain facilities, and pay healthcare providers. Unlike public healthcare organizations, private organizations typically do not rely on government funding or charity work as their primary source of income.

Why other options are wrong

A. Through volunteer work and charity events.

While volunteer work and charity events may contribute to private healthcare organizations in a secondary role, they are not the primary source of funding. These activities do not generate the consistent revenue needed to support the organization's operations and services at the scale required. Private healthcare relies heavily on patient payments and insurance rather than donations or volunteer work.

C. Through government grants and public funding.

Private healthcare organizations do not rely on government grants or public funding, which are typically available to public healthcare institutions. Private organizations are independent and are funded through payments directly from patients or their insurance companies, not from taxpayers' money or governmental support.

D. Through donations and community fundraising.

Although some private healthcare organizations may receive donations or engage in community fundraising efforts, this is not the primary method of funding. Donations and fundraising events are supplementary and do not provide the stable, ongoing financial support needed for day-to-day operations.

Correct Answer

A. Lower overall healthcare costs due to fixed premiums

Explanation

One of the primary advantages of Health Maintenance Organizations (HMOs) for employers is that they often have fixed premiums, which help control and lower overall healthcare costs. This is because HMOs focus on preventative care and managing costs through a network of providers, which helps employers predict their healthcare expenses more accurately.

Why other options are wrong

B. Greater flexibility in choosing healthcare providers

HMOs are typically more restrictive in terms of provider choice. Employees in HMOs must choose from a network of approved providers, limiting their flexibility compared to other healthcare plans like PPOs (Preferred Provider Organizations).

C. Higher reimbursement rates for services rendered

HMOs generally do not offer higher reimbursement rates. Instead, they provide a fixed rate for services, focusing on managing costs rather than increasing reimbursements.

D. Increased administrative burden on the employer

HMOs are designed to streamline administrative processes by having a managed network of providers. This reduces the administrative burden for employers, as the HMO handles much of the coordination and billing. Therefore, this option is incorrect as an advantage for employers.