.Question 13Which of the following best describes the DRG system?1 pointIt incentivizes efficient care by paying hospitals based on patient characteristics, not length of stay or services performedIt is compatible with paying a hospital on a fee-for-service basisIt gives a hospital a single payment for a patient with a given diagnosis, regardless of whether or not that patient is an “outlier”It is a form of retrospective payment

7.Question 7Which of the following is MOST likely to incentivize health care providers to over-utilize medical care?1 pointFee for service payment systemPaying physicians a salaryUsing “supply-side” tools such as gatekeepersCapitation payment systemIncreasing the number of expensive but not readily accessible diagnostic tools and services

Question 9Which of the following is true of capitation?1 pointCapitation shifts risk from the provider to the insurer.Physicians will benefit from having as few people in their panel as possible.Capitation incentivizes providers to provide fewer costly, time-intensive services than fee for service payments. Capitation combats the problem of adverse selection since providers will want to take the sickest patients. Capitation pays the provider a fixed amount for a specific service; for example, one knee replacement. 10.Question 10Which of the following is true regarding the US healthcare system?1 pointLarger practices are more likely to have complete patient data than smaller practicesPatients can only see physicians within the same practice so that all of their data is streamlined into one EHR recordWhen payment records are used, those from capitation systems are more useful than those from fee-for-service systems in assessing care utilizationPayment records are not a useful source of data, as they often do not accurately reflect the amount of care given to a patient11.Question 11Hospitals in the US can:1 pointOperate on a for-profit or a not-for-profit basisBe publicly or privately ownedBe teaching or non-teachingHave or lack an emergency department (ED)Have or lack an intensive care unit (ICU)All of the above12.Question 12Which of the following accurately describes a hospital network, in the context of U.S. health insurance?1 pointAll hospitals within the same geographic areaThe group of physicians with admitting privileges at a hospitalA group of hospitals with whom an insurer works, and whose enrollees are encouraged to useNone of the above

3.Question 3Which of the following does NOT accurately describe the Medicare Fee Schedule?1 pointIt is weighted in part by both the work a physician puts into a given procedure as well as the risk a physician undertakes in doing that procedureIt is updated from time to timeIt was developed by private insurance companiesDetails about it are available for public use

2.Question 2Which of the following is true regarding the US healthcare system?1 pointLarger practices are more likely to have complete patient data than smaller practicesPatients can only see physicians within the same practice so that all of their data is streamlined into one EHR recordPayment records are not a useful source of data, as they often do not accurately reflect the amount of care given to a patientWhen payment records are used, those from capitation systems are more useful than those from fee-for-service systems in assessing care utilization

Question 1Briefly describe a fee-for-service and a capitated physician payment model. Can you name one reason a physician might prefer each?