Healthcare Delivery Systems: Types, Structures, and Governance

Question 1

Which characteristic is unique to managed care systems?

Accepted Answer

Capitation payments to providers

Answer

Emphasis on specialist-led care

Answer

Absence of a gatekeeper system

Answer

Exclusively fee-for-service payments

Question 2

In a fee-for-service payment model, how are providers typically compensated?

Accepted Answer

A set fee for each specific service provided

Answer

A monthly or annual salary

Answer

Based on the quality of care delivered

Answer

Based on the number of patients seen

Question 3

Which of the following best describes the fundamental goal of value-based healthcare?

Accepted Answer

Achieving a balance between quality, cost, and patient satisfaction

Answer

Maximizing the quality of care provided

Answer

Minimizing healthcare costs

Answer

Enhancing the patient experience

Question 4

Which of the following options most accurately describes a preferred provider organization (PPO)?

Accepted Answer

A type of managed care organization that contracts with healthcare providers to offer discounted services to members

Answer

A single-payer healthcare system in which the government is the sole payer for all healthcare services

Answer

A fee-for-service payment model in which providers are paid directly by patients for each service provided

Answer

A not-for-profit organization that provides health insurance coverage to low-income individuals

Question 5

In contrast to multi-payer healthcare systems, what is the defining feature of single-payer healthcare systems?

Accepted Answer

Healthcare is financed through a single entity, typically the government

Answer

Healthcare is primarily funded through private insurance companies

Answer

Patients have the freedom to choose any healthcare provider they wish

Answer

Healthcare costs are significantly lower than in multi-payer systems

Question 6

Which of the following is NOT a characteristic of a fee-for-service healthcare system?

Accepted Answer

Emphasis on preventive care and population health

Answer

Patients are charged for each medical service received

Answer

Providers are reimbursed based on the number of procedures performed

Answer

Lack of coordination among healthcare providers

Question 7

Which of the following is NOT a type of managed care plan?

Accepted Answer

Indemnity insurance

Answer

Health maintenance organizations (HMOs)

Answer

Preferred provider organizations (PPOs)

Answer

Point-of-service (POS) plans

Question 8

Which of the following is a distinct feature of fee-for-service healthcare systems?

Accepted Answer

Compensation to providers based on services rendered

Answer

Unlimited healthcare spending for patients

Answer

Minimal competition between healthcare providers

Answer

Restrictions on patient choice of providers

Question 9

Identify the option that does not represent a type of managed care healthcare system:

Accepted Answer

Indemnity plans

Answer

Health Maintenance Organizations (HMOs)

Answer

Preferred Provider Organizations (PPOs)

Answer

Point-of-Service plans (POSs)

Question 10

Which characteristic is NOT typically associated with managed care systems?

Accepted Answer

Fee-for-service payment structure

Answer

Emphasis on cost containment

Answer

Prevention-oriented approach

Answer

Coordination of care

Question 11

Identify the healthcare delivery system model characterized by government funding and provision of services:

Accepted Answer

National health service

Answer

Managed care organization

Answer

Private health insurance system

Answer

Fee-for-service system

Question 12

Which objective is NOT a focus of healthcare reform efforts in the United States?

Accepted Answer

Maintaining healthcare costs

Answer

Expanding access to care

Answer

Enhancing quality of care

Answer

Ensuring universal coverage

Question 13

What is the primary responsibility of a board of directors in a healthcare organization?

Accepted Answer

Define the organization's mission and vision

Answer

Hire and dismiss the CEO

Answer

Monitor the organization's financial performance

Answer

Provide direct patient care

Question 14

Which payment model rewards healthcare providers based on meeting specific quality metrics?

Accepted Answer

Value-based payment

Answer

Capitation

Answer

Fee-for-service

Answer

Bundled payment

Question 15

Classify the three primary levels of preventive care:

Accepted Answer

Primary, secondary, tertiary

Answer

Diagnostic, therapeutic, rehabilitative

Answer

Outpatient, inpatient, long-term

Answer

Preventive, acute, chronic

Question 16

The primary goal of a healthcare delivery system is to:

Accepted Answer

Enhance the overall health of the population

Answer

Maximize profits for healthcare providers

Answer

Reduce healthcare costs

Answer

Provide cutting-edge medical technology

Question 17

What is a fundamental distinction between public health and healthcare?

Accepted Answer

Public health focuses on the health of the entire population, while healthcare focuses on individual health

Answer

Public health is primarily funded by government sources, while healthcare is funded by private insurance

Answer

Public health is largely unregulated, while healthcare is subject to extensive regulations

Answer

There is no meaningful distinction between public health and healthcare

Question 18

Which of the following is NOT a characteristic of a managed care system?

Accepted Answer

Patients have a limited range of choices in healthcare providers.

Answer

Cost containment measures are used.

Answer

Emphasis on preventive care.

Question 19

Which type of healthcare delivery system is characterized by a group of physicians who share ownership of a medical practice and make decisions collectively?

Accepted Answer

Group practice.

Answer

Health maintenance organization (HMO).

Answer

Independent practice association (IPA).

Answer

Preferred provider organization (PPO).

Question 20

Which type of governance model grants physicians significant influence over decision-making in healthcare organizations?

Accepted Answer

Medical staff model.

Answer

Trustee model.

Answer

Hybrid model.

Answer

Corporate model.

Question 21

Which of the following is a potential benefit of a single-payer healthcare system?

Accepted Answer

Reduced administrative expenses.

Answer

Greater emphasis on preventive medicine.

Answer

Increased patient choice.

Answer

Guaranteed improved quality of care.

Question 22

Which of the following is a major drawback of the fee-for-service payment model?

Accepted Answer

It can incentivize overutilization of healthcare services.

Answer

It is difficult to administer.

Answer

It discourages preventive care.

Answer

It undermines physician autonomy.

Question 23

Which of the following is a core element of the patient-centered medical home (PCMH) model?

Accepted Answer

Collaboration and teamwork in patient care.

Answer

Primary focus on acute care.

Answer

Reimbursement based on fee-for-service.

Answer

Limited patient access to specialized care.

Question 24

Which of the following is an objective of value-based healthcare?

Accepted Answer

Enhancing patient outcomes and reducing overall healthcare costs.

Answer

Reducing patient wait times.

Answer

Increasing the number of healthcare providers.

Answer

Expanding access to healthcare services.