HAP301 Quiz 3 - Quiz 3(36/40 An MS-DRG is a refined DRG...

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Quiz 3 (36/40) An MS-DRG is a refined DRG that includes patient severity costs incurred in treating a patient adjustment for treating patients on Medicaid adjustment for readmissions within 30 days of discharge The majority of beneficiaries receiving health care through Medicare are elderly disabled financially poor those suffering from end-stage renal disease In general, how do bronze, silver, gold, and platinum health plans differ? They differ according the benefits offered. They differ according to cost sharing. They differ according to both benefits and cost sharing. They differ according to the length of service with an employer. When a fixed monthly fee per enrollee is paid to a provider, it is called Bundled fee Charge Capitation Retrospective reimbursement Medicare Part B premiums are standard for everyone market-based income-based None of the above Capitation removes the incentive to control costs. provide unnecessary services. file a reimbursement claim.
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underutilize health care. What is the main function of the Medicare Payment Advisory Commission (MedPAC)? To determine Medicare reimbursement to various providers To advise the US Congress on various issues affecting the Medicare program To control total Medicare expenditures To establish Medicare policy How is case mix determined for an inpatient facility? A comprehensive assessment of each patient is done. Patients are classified according to case-mix groups. A case-mix index is created. Case mix is determined by the principal diagnosis of each patient. A DRG represents cumulative days of care a group of principal diagnoses bundled fees established prospectively number of discharges from the hospital National health expenditures (E) = P x Q Q / P P / Q (P x Q) / P The ACA specifies that ______ can be covered under their parentsâ health insurance plans. Children attending college Children who are unemployed Children up to the age of 19 Children under the age of 26 What is the Minimum Data Set (MDS)?
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