Health Care Administration Practice Exam

These questions are part of the practice quiz. Start practicing

• What is the name of the government-regulated marketplace that offers health insurance plans with varying levels of coverage for individuals and small businesses?
• Which phrase best describes palliative care for patients with serious illness?
• The 2010 health reform act aimed to expand insurance coverage and reform care delivery. Which phrase best captures this aim?
• What term refers to secure digital tools that provide patients access to their own health information and allow communication with providers?
• A limited group of providers who offer discounted fees and agree to utilization review.
• A count of unnecessary deaths from diseases for which effective interventions are available is called what?
• Which description best captures the essence of the Patient-Centered Medical Home (PCMH)?
• Which term describes an insurer that underwrites risk and reimburses costs under group policies or contracts in exchange for premiums?
• Which HMO structure contracts with physicians who practice in private offices but operates within a defined network of providers?
• Which term best describes hospice care, providing palliative and supportive services for dying patients and bereavement support for families?
• Physicians, usually hospital employees, who practice only in acute care settings to provide inpatient care otherwise provided by attending physicians are called what?
• Which term refers to an association of independent physicians created to contract with health plans?
• Which model involves physicians who practice in private offices under contract with the HMO rather than being employees?
• A fixed amount per service paid at the time of service is most aligned with which term?
• Which act introduced a Medicare prescription drug benefit and a drug discount card?
• The combination of knowledge, skills, personal characteristics, and behaviors needed to perform a job effectively is called what?
• Which term describes a registered nurse with a master's or doctoral degree concentrating on a specific area of practice?
• What term refers to the human genetic code, involving billions of base pairs in the DNA sequence across the 23 human chromosomes?
• Which term describes enabling conditions such as living conditions, social support, resources, and skills that enable behavior change?
• Which term describes conditions for which hospitalization could be avoided with outpatient care?
• Health services provided in an individual's home are called what?
• What term maps out day-to-day recommendations for patient care based on best practices and evidence?
• Studies that compare two or more health care technologies, products, or services against each other or against the standard of care are known as what?
• What term denotes the death of a child born alive before age one?
• Which term refers to a system established by a state recognizing education, experience, and examination performance to work in a defined area of practice?
• In a hospital, what term refers to the number of patients present at a given moment?
• Which term identifies the role that controls access to services within HMOs by authorizing or denying care?
• Which HMO arrangement contracts with physicians who practice in private offices under contract with the HMO rather than being employees?
• Which term denotes the health coverage marketplace created to offer plans with different levels of coverage?
• What term describes care for needy patients without expectation of payment?
• In health care metrics, what term is defined as the total number of people among whom numerator items are counted?
• The use of the best available evidence to make management decisions is called what?
• Which term encompasses therapies such as chiropractic, acupuncture, and naturopathy that fall outside standard medical practice?
• Which private insurance sold to cover Medicare gaps is known as what?
• Which organization sponsors the HEDIS measures?
• Which description best defines a Multispecialty Group Practice (MSGP)?
• What term describes the number of new events, disease cases, or conditions counted in a defined population during a defined period?
• Which term describes a broker organization that arranges with physician groups, carriers, payer agencies, and other entities for services provided to enrollees?
• Which term refers to professional health service workers licensed to practice independently?
• What term describes the state recognition allowing professionals to work in a defined area of practice?
• The formula that updates probability with new evidence is called what?
• Which term describes an entity, usually a hospital or physician group, that accepts responsibility for the medical care of a defined population and uses financial incentives to improve cost patterns for that group?
• In a health care organization, which term best describes individuals or groups with an interest in how the organization performs?
• Which term is defined as the use of living organisms and biological systems to develop medical products and treatments, and is used in fields like agriculture and plastics?
• What term describes affiliations among providers of the same type, such as hospitals forming relationships with other hospitals?
• In a managed care framework, which arrangement offers lower rates for using in-network providers?
• What is the term for the predicted average number of years of life remaining for a person at a given age?
• An Office Visit is best described as?
• What term is used for a hospital owned by private parties or a corporation for the purpose of generating a profit?
• What term describes the testing of patients in a clinical setting using a design that estimates safety and efficacy?
• Which term refers to requiring individuals to cover some part of their medical expenses (coinsurance, deductibles)?
• A physical or mental condition that exists before issuance of a policy.
• What term describes a group of health care organizations that collectively provides a full range of health-related services in a coordinated fashion?
• The activity of an organization that monitors the outside environment, selects appropriate alternatives, and negotiates the implementation of these alternatives with others inside and outside the organization?
• In health, an event, condition, or disease occurrence that is counted, including episodes of care and cost of care, is represented by which term?
• Which term describes a coordinated group of health care organizations providing a full range of services?
• Which term denotes an organizational relationship for specific purposes?
• The term for the best known value for a measure from any source; often used for comparison is what?
• What term describes insurance coverage for most inpatient hospital costs, including room and board, emergency care, labs, and certain procedures?
• Under a DRG framework, the term for long-stay hospital cases that receive extra payments is long-stay outliers.
• A system where the provider is paid a fixed amount for each service rendered is called what?
• Which term best describes the systematic focus on improving health outcomes by analyzing determinants and shaping policy?
• A hospital offering short-term general and other services, owned by a corporation or agency other than the federal government, is described as what?
• Which term describes guidelines adopted by organizations and governments that promote constrained decision making and limit subsequent choices?
• In medical education, what term describes the education and training of physicians after medical school, including internships, residencies, and fellowships?
• Which term is a type of insurance that pays for high-cost health care, typically for injuries and chronic conditions like cancer and AIDS?
• Which term describes a specified amount an insured individual must pay for a specified service?
• Purchasing more of something because someone else's money pays for all or part of it.
• Which term denotes government benefits automatically provided to all qualified individuals as part of mandatory spending?
• A periodic payment required to keep an insurance policy in force.
• A method of providing, in advance, for the cost of predetermined benefits for a population group through regular periodic payments.
• What is the term for actions people take to maintain, attain, or regain good health?
• What payment method reimburses providers for each day of service, based on the patient’s illness or condition?
• Which term refers to an insurer that underwrites risk and reimburses costs under group policies in exchange for premiums?
• Which term describes programs providing financial support to low-income individuals or families, such as TANF, SSI, and UI?
• Which phrase defines the provision of preventive, treatment, or rehabilitative health services by practitioners, institutions, or public health agencies?
• Which term describes a written instruction from a licensed physician to a pharmacist to dispense a specific medication?
• The term 'Network' in health care delivery refers to?
• What term refers to state-level approval required for major new hospital services or construction?
• What term refers to groups of inpatient discharges with final diagnoses that are similar clinically and in resource consumption, used as a basis for Medicare payment?
• One or more disorders occurring simultaneously or sequentially with a primary disorder is called what?
• A therapeutic drug, originally protected by a patent, the chemical composition of which meets the standards for that drug set by the Food and Drug Administration, usually manufactured by a different company than the branded drug?
• Which term describes a physician who practices independently without sharing personnel or equipment with others?
• Which term describes the maximum amount a health program will pay for a specified service under a plan?
• Which concept focuses on how social and economic conditions influence health outcomes, including factors like where people are born and live?
• Which term refers to government benefits automatically provided to all qualified individuals as part of mandatory spending?
• Which law enacted in 2010 aimed to expand health insurance coverage and improve quality and reform health care delivery?
• Which term describes the process of coordinating care and identifying the expected discharge date within a hospital?
• Which term counts episodes of care, expenditures, and resource utilization to assess health service performance?
• In a health care organization, which term best captures individuals or groups with an interest in the organization's performance?
• Which practitioner is a specially trained and licensed professional who can perform certain medical procedures under the supervision of a physician?
• What term refers to the amount insured individuals must pay out-of-pocket annually before insurance begins to cover costs?
• Which federal law requires employer-sponsored health plans to offer continuation of health insurance coverage after certain qualifying events?
• National Health Insurance is best described as?
• An amenity or activity offered to promote the welfare of individuals or groups, often provided by government or charitable organizations, is called what?
• Which entities are owned by private corporations that declare dividends or distribute profits to individuals, also called investor-owned; many are community hospitals?
• Which model describes an approach to primary care that is patient-centered, comprehensive, team-based, and coordinated?
• What term is used to denote the count of members of the national population and their demographic characteristics collected by the U.S. Census Bureau every 10 years?
• Which term describes the predicted average number of years a person is expected to live from birth?
• An order from a physician to dispense medication.
• The health plans made available to federal employees as part of their employment benefits are referred to by which term?
• A term used to describe the amount of money spent on health care. Example: a loss ratio of 0.85 spends 85 cents of every premium dollar on health care and remaining 15 cents on administrative costs.
• The general health care delivered routinely not tied to acute diseases; often provided by clinicians including physicians and nurse practitioners.
• What term describes electronic systems that store, retrieve, manipulate, and communicate information in health care?
• What does mortality refer to in health care metrics?
• Which term describes a physician-directed medical practice with a personal physician coordinating care?
• What term describes long-term care services provided for more than 30 days in inpatient or ambulatory settings?
• Diagnosis-Related Groups (DRGs) are used as a basis of payment by which program?
• Which setting best describes a National Health Service (NHS) model?
• Which term describes the characteristics of a population such as age, sex, marital status, ethnicity, geographic location, occupation, and income?
• Which term relates to physicians ordering tests or treatments primarily to shield themselves from legal risk rather than patient need?
• Which model typically contracts with a single large physician group to provide all medical services for members?
• A facility providing care for patients who no longer require hospital treatment but still need 24-hour medical care or rehabilitation is called a ...
• A billing system in which a health care provider charges a patient a set amount for each individual service is known as what?
• An HMO that employs providers who see members in their own facilities is best described as which model?
• What does EMR stand for in health informatics?
• What term describes a nursing role with advanced clinical responsibilities, including diagnosis and treatment?
• Which term is used for the process that ensures healthcare providers' credentials are current before reimbursement?
• What term refers to an association of independent physicians formed as a separate legal entity for contracting with health plans?
• Out-of-Pocket expenses refer to what type of costs?
• Which term describes the health plans taught to federal employees as part of employment benefits in an exam-style context?
• What term describes electronic systems used to store, retrieve, manipulate, and communicate information within a health care organization?
• Under HIPAA, which agency's Office for Civil Rights enforces privacy standards for medical information?
• Which term describes programs and services offered by medical care providers to improve community health and increase access to health care?
• What term describes passing the excess costs of care for one group onto another group?
• Which term describes a person eligible for services under a health plan contract, such as a subscriber or dependent?
• Care for which expected health benefits exceed negative consequences is called what?
• Who updates the Healthy People objectives every decade?
• Which term describes a broad approach to coordinating care, ensuring patients receive needed services, and may involve social services in addition to medical care?
• A person's capacity to perceive, control, express, and evaluate emotions in interpersonal relationships is known as what?
• What term describes a physician who graduated from a medical school outside the United States that is not accredited by the US accrediting body?
• A residential option that provides assistance with activities of daily living outside a hospital setting is called what?
• What is the name for a listing of drugs prepared by a hospital or managed care company that a drug plan will pay for?
• A hospital that provides a large amount (disproportionate share) of uncompensated care is called what?
• Enrollment is the process of becoming a subscriber for health plan coverage. Which four options best reflect this concept?
• The process of electronically entering medical practitioner instructions for the treatment of hospitalized patients is known as what?
• Which term describes plan coverage areas such as outpatient visits, hospitalizations, or prescription drugs that make up the medical services offered by a health plan?
• Which program, alongside Medicare and Medicaid, provides health coverage for children in low-income families?
• Palliative care programs that operate in different settings to provide care for dying patients and bereavement support for families are known as what?
• Which epidemiologic measure counts new cases in a population during a specified period?
• A safety-net provider is best described as a person or institution that delivers care for free or at reduced cost to low-income and/or uninsured patients.
• The average number of people staying overnight in a hospital bed on a typical day is known as what?
• Which term describes all people who work in the health care services industry?
• Which term describes an individual who coordinates and oversees other health care workers to find effective care methods and arrange services for specific patients?
• A method used to determine health insurance premiums based on prior group spending is known as what?
• Which term describes the phenomenon where a population characteristic leads to higher health service utilization and costs?
• A physician who practices alone and does not share personnel or equipment with three or more physicians is described as what?
• Which health professional is a nurse with extra training who can diagnose and treat patients?
• Benefits that a health plan is required to provide by law. Generally refers to benefits above and beyond routine insurance-type benefits, and generally applies at the state level.
• Which model focuses on proactive care aimed at keeping people healthy and emphasizes patient self-management?
• A method used to determine the cost of health insurance premiums based on the previous amount a group paid for medical services is called what?
• Which term is used to describe an HMO that retains salaried physicians working within the organization's clinics?
• What term refers to the complete set of genetic material present in a human cell?
• Which term describes care that is provided over a long period with the goal of maintaining health and facilitating self-management?
• An account similar to an IRA that funds tax-deferred contributions to pay medical expenses is called what?
• Which term refers to an individual's ability to obtain medical services in a timely and financially acceptable manner?
• Which stakeholder group is most directly concerned with the financial performance of a health care organization?
• A.K.A Medicare supplemental insurance, private coverage that may be purchased to cover services not covered by Medicare Part A or B.
• Which formula is used to revise predictions or theories given new evidence?
• Which arrangement features three or more physicians who deliver care, share equipment and personnel, and divide income by a prearranged formula?
• Diagnostics and treatment interventions outside the realm of state-licensed medical practice, including chiropractic and acupuncture, fall under which category?
• Which term is a decision by a recognized organization that an institution substantially meets defined standards?
• A portion of the COBRA law setting forth requirements for hospitals participating in Medicare to provide emergency care so that patients who cannot pay are not dumped is EMTALA. Which option best fits the acronym EMTALA?
• Which term refers to a digital record that consolidates comprehensive patient history from multiple providers?
• Which process involves measuring, monitoring, and improving staff performance to enhance overall organizational performance?
• Which term is the formal recognition that an organization meets defined standards?
• Which term describes a contract to provide services to beneficiaries under which the health plan receives a fixed monthly payment for enrolled members and then must provide all services on an at-risk basis?
• Which term is commonly used as an epithet by opponents of any national government involvement in financing or operating a national health care delivery system?
• Which term refers to a payment arrangement where a provider is paid a fixed amount to address a specific medical problem, potentially covering services, devices, and facilities?
• Which term refers to a hospital’s obligation to spend funds on community benefits based on its tax status and public funds?
• Digital records that contain a comprehensive patient medical history, combining information from multiple provider sources are known as what?
• An episode of sickness, as defined by a health professional. A morbidity rate is the number of such episodes occurring in a given population during a given period of time.
• Which term describes physicians who focus solely on inpatient care in hospital settings, often employed by hospitals?
• An element of personal behavior such as smoking, poor diet, or lack of physical activity describes what?
• Which statement describes an Open Enrollment Period?
• A system of health care delivery that influences or controls utilization of services and costs of services. The degree of influence depends on the model used; for example, PPO charges lower rates if they use in-network providers, and HMOs may not reimburse out-of-network.
• Which model emphasizes a network of contracted physicians who may operate in multiple office locations rather than in a single facility?
• Which term describes individuals who qualify to receive benefits under both Medicare and Medicaid?
• Which term describes a managed care organization that arranges and provides health care for enrollees for a fixed prepaid premium?
• Under which model does a health plan receive a fixed per-member monthly payment and then bear the cost of all care?
• A patient visit to a provider in capitated health plans is called what?
• What insurance feature limits coverage to a fixed percentage, with the remainder paid out of pocket by the member?
• What term refers to individuals who do not have and cannot afford medical insurance but are financially eligible for Medicaid?
• The number of people who stay overnight in a hospital bed on a typical day at a specific hospital is also known as what?
• Under a DRG payment system, which term refers to hospital cases with extraordinarily long stays that receive additional per diem payments?
• Which term describes the body responsible for setting policy and strategic direction for an organization, often described as the board of directors?
• Which term best describes an HMO where physicians are salaried employees and render care within the HMO's clinics?
• Which term refers to a nationwide government-operated health care payment system?
• What term describes a health plan that contracts with a medical group and typically operates on a closed panel?
• An element of personal behavior—such as unbalanced nutrition, use of tobacco products, leading a sedentary lifestyle, or the abuse of alcohol—that increases disease risk is called what?
• What is the term for a managed care plan that contracts with physicians to see members of another MCO?
• Which term refers to preexisting characteristics that influence a health-related behavior?
• Which program is a federal entitlement for the elderly and disabled, including those with end-stage renal disease?
• Which term describes a payment approach in which a physician or hospital is paid a fixed amount per patient per year, irrespective of services used?
• Which term describes contributions made by employers to a health and welfare fund on behalf of employees?
• Which term best describes the specific areas of plan coverage such as outpatient visits, hospitalizations, or prescription drugs?
• Which term describes when a population characteristic increases health services utilization and costs above the capitation rate?
• A health insurance system that pays for a broad range of services is called what?
• The rating approach that uses the total experience of subscribers in a geographic area to set a uniform reimbursement rate is known as what?
• Which insurance type pays predetermined benefits regardless of actual expenses and generally imposes fewer restrictions on charges?
• Which benefits plan gives employees a total compensation amount to allocate among various benefits rather than specific benefits?
• Which term describes the evaluation of health care interventions to determine value, including costs and benefits?
• Which term refers to actions taken to influence public policy, resource allocation, and other decisions?
• A general term for a range of services provided to chronically ill, physically disabled, or mentally disabled patients in a nursing home or through long-term health care.
• Which arrangement is characterized by physicians who remain independent and contract with the HMO, rather than being employed?
• Which term is defined as enabling conditions that facilitate behavior change?
• Which term best describes the people who work in the health care services industry, including both professionals and nonprofessionals?
• Which term refers to the standard set of performance measures of health plan quality sponsored by the National Committee for Quality Assurance (NCQA)?
• What term describes a listing of accepted fees or allowances used by health plans, representing the maximum amounts the program will pay for a specified service?
• Which term describes a payment model where a fixed amount is paid for a specific medical problem, covering services, devices, and possibly the surgical suite?
• Which program is the major source of payment for nursing home care of the elderly?
• Doctors in family practice, general internal medicine, obstetrics/gynecology, or pediatrics; nurse practitioners and midwives; may also include psychiatrists and emergency care physicians.
• Which federal law offers Medicare beneficiaries prescription drug coverage and a drug discount card?
• The term used for the rate at which illness occurs in a population during a period is called what?
• Which term describes a payment method where a physician or hospital is paid a fixed amount per patient per year, regardless of services used?
• Which term refers to costs that do not change with fluctuations in enrollment or utilization of services?
• Which concept uses the total experience of subscribers within a geographic 'community' to determine a reimbursement rate common for all groups?
• Which concept represents studies that compare the value and cost effects of different health care interventions?
• Which formal national health objectives set aims to be achieved by 2020 and is updated every decade by the federal government?
• The circumstances in which people are born, grow up, live, work, and age, and the systems addressing illnesses shaped by larger forces are referred to as what?
• Which term refers to medical care of a limited duration, provided in a hospital or outpatient setting?
• Which HMO arrangement involves contracting with a single medical group to deliver care to enrollees?
• Which term describes a program for providing group insurance with benefits financed entirely through the internal means of the policyholder, avoiding premiums paid to commercial carriers?
• Which term refers to the system that coordinates care and payment under a prepaid plan, often associated with HMOs?
• Which term refers to care for individuals with advanced, progressive, incurable illnesses to live as well as possible until they die?
• Which term refers to a listing of drugs that a drug plan will pay for?
• Which term refers to an insurance provision commonly implemented at 80% coverage, with the remainder paid as out-of-pocket costs?
• Which housing option is designed for seniors age 55 and older who do not require daily assistance but may benefit from services and social opportunities?
• Which term describes the process of combining two organizations at the same level of care, such as hospitals merging?
• Which term refers to an individual who coordinates and oversees health care workers in caring for patients and arranges necessary services?
• Which term describes hospitals and other providers affiliated with a medical school that participate in training and clinical research?
• Clinical and supportive activities intended to treat or manage mental illnesses and/or alcohol or substance abuse are called what?
• Which term represents the days billed for a hospitalization period?
• A Nurse Practitioner is defined as?
• Which concept encompasses pain and symptom management along with emotional and spiritual support for patients facing serious illness?
• Which term describes a policy design that gives employees a fixed amount of compensation to allocate among benefits?
• Doctors who have privileges to use a particular hospital for inpatient care of their patients are called what?
• Which term best encapsulates the health outcomes of a group and the distribution of those outcomes, and the field that analyzes how determinants influence policies and interventions?
• The plan design that allows use of participating or nonparticipating providers with cost-sharing differences is called a?
• What term describes a systematic approach to improving processes in health care, such as admission to the hospital or delivery of patient medications?
• Which description matches Open Enrollment Period?
• What are entities that link individuals to health insurance offerings and support enrollment under health reform initiatives?
• The National Health Service is best characterized as?
• What term describes a way of calibrating the workforce used when some employees work part time and some employees work full time?
• The use of marketing to design and implement programs to promote socially beneficial behavior change is called what?
• Natality is the term used to describe which of the following?
• The most common use of the term refers to obtaining and reviewing the documentation of professional providers. Which term is this?
• Which statement best describes a Nurse Practitioner?
• Which term describes individuals or groups with an interest in how an organization performs?
• The general health care delivered routinely; often described as care provided by clinicians such as physicians and nurse practitioners.
• Which term refers to the identification, evaluation, and corrective action against organizational behavior that could result in financial loss or legal liability?
• The practice of physicians recommending a diagnosis test or treatment not necessarily optimal for the patient but to protect against malpractice suits is called?
• What term denotes the admission of a patient to a hospital?
• Which term describes hospitals that are owned by private corporations and distribute profits to shareholders?
• A component of the patient management plan that identifies the expected discharge date and coordinates services to achieve it is called what?
• Which concept uses marketing principles to design and implement programs that promote socially beneficial behavior change?
• Which term describes hospitals and other providers affiliated with a medical school that participate in training and clinical research?
• What term describes a health care practitioner who makes decisions regarding the type and volume of services to which a patient may have access; generally used by health maintenance organizations (HMOs) to control unnecessary utilization of services?
• Organizations that operate multiple service units under single ownership are known as what?
• Which model involves physicians who practice in private offices under contract with the HMO rather than being employees?
• Which type of health insurance pays a predetermined amount for a covered loss, rather than reimbursing actual expenses?
• Which federal law sets standards for disclosure of employee benefit plans and preempts state laws regarding health benefits?
• Which term denotes an organizational relationship formed for specific purposes?
• Services provided to individuals who need assistance with activities of daily living describe what living arrangement?
• The science and art of helping people change their lifestyles to achieve a state of optimal health, defined as a balance of physical, emotional, social, spiritual, and intellectual health, is called which term?
• What is the term for the set of procedures traditionally used by Western physicians to diagnose and treat illnesses?
• Which term describes affiliations between providers at different stages of the health care delivery process, such as a hospital partnering with a physician practice?
• Which term refers to affiliations among providers of different types (hospitals, clinics, and nursing homes) forming an affiliation?
• Which term describes a care delivery arrangement where providers share responsibility for the medical care of a defined population and aim to improve cost patterns?
• Which term covers financial support programs such as SNAP and WIC?
• In which HMO arrangement are physicians most likely employed by the HMO and physically stationed in the HMO's facilities?
• Which agency administers Medicare, Medicaid, and CHIP?
• What term refers to the resources needed to carry out a process or provide a service in health care?
• An amenity or activity offered to promote welfare by government or charitable groups is called?
• Which role is defined as performing certain medical procedures under physician supervision?
• That portion of medical practice estimated to be much less than 50% and based on established scientific findings is known as what?
• Which term describes a patient-centered approach with an ongoing relationship to coordinate care?
• In health care statistics, what term defines the population base used for calculating rates?
• Which term describes doctors including family practice, general internal medicine, obstetrics/gynecology, and pediatrics, as well as nurse practitioners and midwives?
• The best known value for a specific measure, from any source, is called what?
• A group of individuals who, under state law, own an organization, regardless of whether they can obtain any financial advantage through such ownership?
• Which managed care plan offers enrollees the option to receive care from participating or nonparticipating providers, with cost-sharing designed to steer usage?
• Which program is designed to provide health coverage for low-income individuals?
• Which term refers to tasks required for a person's normal functioning?
• Key provisions of which federal law improve health coverage when workers change or lose jobs and establish privacy standards for medical information overseen by OCR?