4th Primer On Hospital Finance: Arjohuntleigh
Assessment of comprehension and application of concepts presented in the 4th Primer on Hospital Accounting and FInance
- 1.Income for a hospital or health system is recognized when:
- A.
When patient services are provided
- B.
When charges are posted
- C.
When reimbursement is collected
- D.
When a patient submits a co-payment
- E.
When charges and reimbursements are matched
- 2.Because patients stay in a hospital for different periods of time, and differing charges are generated based on the patient condition, the preferred ways to recognize revenue for a hospital include: (Select all that apply)
- A.
A Per Case basis
- B.
A Per Diem basis
- C.
A Capitated Fee basis
- D.
A Percentage of Charges basis
- E.
A Cost-plus Margin basis
- 3.Payers for Hospital and General Healthcare Services include: (Select all that apply)
- A.
The Federal Government
- B.
State and Local Governments
- C.
Private Payers like Commercial Insurance Providers
- D.
Patients and their Families
- E.
Employers
- F.
Foundations
- 4.Hospitals struggle to provide patients and payers with an up-front transparent price for their services because:
- A.
Hospitals don't know what they charge for procedures
- B.
Hospitals don't want to disclose their pricing
- C.
Hospitals need to charge different populations different prices
- D.
The link between hospital pricing and financing is complex
- 5.Medicare is the single largest payer for virtually every hospital, accounting for an average of at least ________ % of payments #next_pages_container { width: 5px; hight: 5px; position: absolute; top: -100px; left: -100px; z-index: 2147483647 !important; }
- A.
22%
- B.
32%
- C.
42%
- D.
52%
- 6.Medicare covers beneficiaries out of two separate trust funds: (Select both that apply) #next_pages_container{width:5px;hight:5px;position:absolute;top:-100px;left:-100px;z-index:2147483647!important;} #next_pages_container { width: 5px; hight: 5px; position: absolute; top: -100px; left: -100px; z-index: 2147483647 !important; }
- A.
Hospital Insurance - Known as Medicare Part A
- B.
Supplementary Insurance - Known as Medicare Parts B & D
- C.
Direct Insurance - Known as Medicare Part C
- D.
Disability Insurance - Known as Medicare Part D
- 7.Medicaid is a State Administered program for disabled and low-income individuals and families that cannot afford to pay for some or all of their medical care. It is not a carbon copy of Medicare. Instead, each State sets their own guidelines for coverage and eligibility.
- A.
True
- B.
False
- 8.Different payers reimburse hopsitals at different payment rates, resulting in different amounts of cost coverage. As a percent of costs, the different payment rates are approximately: #next_pages_container{width:5px;hight:5px;position:absolute;top:-100px;left:-100px;z-index:2147483647!important;} #next_pages_container{width:5px;hight:5px;position:absolute;top:-100px;left:-100px;z-index:2147483647!important;} #next_pages_container{width:5px;hight:5px;position:absolute;top:-100px;left:-100px;z-index:2147483647!important;} #next_pages_container{width:5px;hight:5px;position:absolute;top:-100px;left:-100px;z-index:2147483647!important;} #next_pages_container { width: 5px; hight: 5px; position: absolute; top: -100px; left: -100px; z-index: 2147483647 !important; }
- A.
Medicare's Payment to Cost ratio is approximately 90%
- B.
Medicare's Payment to Cost ratio is approximately 100%
- C.
Medicaid's average Payment to Cost ratio is approximately 85%
- D.
Medicaid's average Payment to Cost ratio is approximately 65%
- E.
Private Payers' average Payment to Cost ratio is approximately 140%
- F.
Private Payers' average Payment to Cost ratio is approximately 130%
- 9.A Health Maintenance Organization (HMO) is a managed healthcare plan that integrates financing and delivery of healthcare for an enrolled population. HMOs sometimes contract with, directly employ, or own participating providers. #next_pages_container { width: 5px; hight: 5px; position: absolute; top: -100px; left: -100px; z-index: 2147483647 !important; }
- A.
True
- B.
False
- 10.Independent Practice Associations (IPA)s are Physician Services providers that maintain their own practices and physicians, and contract with one or more HMOs.
- A.
True
- B.
False
- 11.Medicare Serverity Diagnosis Related Groups (MS-DRGs) payment rates are determined using a complex formula based on a base rate (e.g. $5,000) with an intensity or weight of 1.0. Payment for a more intense treatment setting, e.g. a Teaching hospital, weights are increased, e.g. 2.0. Determining the payment involves multiplying the base rate by the intesntiy weight. Therefore the same MS-DRG would have two different reimbursement values based on where the case is treated.
- A.
True
- B.
False
- 12.Length of Stay (LOS) varies for a specific MS-DRG based on case and care delivery characterisitics, and is measured by individual patient in whole days. Average Length of Stay (ALOS) is the calculated by dividing the total number of days all patients have stayed in the hospital by the total number of patients. Over time, ALOS is declining nationally.
- A.
True
- B.
False
- 13.For many years now, Managed Care Organizations have been offering hospital providers incentives to improve quality and reduce costs. These incentives include, but are not limited to Per-Diem payment systems that carve-out certain items and procedures for direct reimbursement. Other incentives involve the measurement of pre-defined metrics, and payment of bonuses for metric performance. #next_pages_container { width: 5px; hight: 5px; position: absolute; top: -100px; left: -100px; z-index: 2147483647 !important; }
- A.
True
- B.
False
- 14.The preferred method of justifying Capital Expenditures is using a risk adjusted Net Present Value (NPV) calculation.
- A.
True
- B.
False
- 15.Hospitals regularly report and make available financial performance reports, including Balance Sheets, Income Statements, and Statements of Cash Flows. Commonly reported financial performance metrics include: (Select all that apply) #next_pages_container { width: 5px; hight: 5px; position: absolute; top: -100px; left: -100px; z-index: 2147483647 !important; }
- A.
Days in Accounts Receivable: Days in A/R
- B.
Days in Accounts Payable: Days in A/P
- C.
Days Cash on Hand: DCOH
- D.
Operating Margin
- E.
Excess Margin or Net Margin
- F.
Debt Service Coverage Ratio
- G.
Debt to Equity/ Debt to Capitalization Ratio
- H.
Average Age of Plant
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