Health Economic Assignment 4
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Health Economic Assignment 4
1. Capitation
a. creates pressures to provide more services.
b. is a fixed payment determined in advance to pay for all medically-necessary care.
c. is the maximum allowable fee in a fee-for-service system.
d. Both a and b are correct.
2. The health maintenance organization where the physicians are salaried employees of the HMO is called
a. a group-model HMO.
b. a staff-model HMO.
c. a network-model HMO.
d. an IPA.
3. The rate of return on an investment in medical education
a. is inversely related to the length of time spent in formal schooling.
b. is inversely related to income.
c. will increase with an increase in the availability of student loans.
d. is much higher than the rate of return on an undergraduate business degree.
4. Physicians who own their own diagnostic testing facilities tend to order more tests, charge higher fees for them, and have higher total bills to patients. This practice of self-referral is an example of
a. moral hazard.
b. adverse selection.
c. physician-induced demand.
d. cognitive dissonance.
5. An important element in estimating the present value of an investment is the calculation of the discount factor. The discount factor may be expressed as _______ where r is the discount rate and n is the number of years the investment is held.
a. (1 + r)n
b. (1 + n)r
c. 1/(1 + r)n
d. 1/(1 + n)r
6. Network model HMOs use _______ to shift financial risk back onto providers.
a. capitation.
b. practice guidelines.
c. open panels.
d. closed panels.
7. What is the motivation behind the cost-control features of managed care?
a. To ensure access to specialty care through general practitioner gatekeepers.
b. To influence the way physicians practice medicine by changing the financial incentive structure of medical care delivery.
c. to shift the financial risk onto patients.
d. to eliminate all the guesswork from diagnoses by establishing practice guidelines.
8. To control moral hazard and the increased spending that accompanies it, managed care providers include _______ in contracts with providers.
a. clinical rules
b. capitation
c. risk sharing
d. all of the above
Short Answer
The coinsurance rate is 20%, the physician’s fee is 50, the value of the person’s time per unit of time is 40/hour , and the total patient time consumed by a visit is one hour.
What is the full price of an office visit? (1 pt)
Ans:
pf=cp+wt =0.2*50 + 40*1 = 10 + 40 = 50
Calculation Problem
Bill’s new insurance policy contains a prescription plan that provides all drugs through a local pharmacy with a $2 copayment (the amount charged the patient per prescription filled). Under the old insurance plan, Bill had to pay for his own medication and purchased nine inhalers at $17 apiece to help control his asthma. With the new plan, Bill purchases fifteen inhalers, keeping some of the spares in his glove compartment and desk, since he only has to pay a $2 copayment for each one.
What is Bill’s consumer surplus under the new plan? (2 pts)
ANS: Refer to the page 5 of the Insurance_Sloan slides.
Under the new plan, Bill’s consumer surplus becomes EC2
(39.5-2)*15/2 =281.25
2022-06-30