Problem
Part I
A. Why is it important to know the risk pool for health insurance?
B. What is the purpose of health insurance?
C. What are the downsides of traditional indemnified health insurance plans? Why have most insurers shifted to managed care?
D. What are the advantages and disadvantages of community rating and experience rating to set health insurance premiums?
E. What causes adverse selection in health insurance?
F. Does moral hazard exist in healthcare?
G. How is a medical loss ratio determined?
H. How does having health insurance improve a person's health?
I. What are the differences between health reimbursement accounts, health savings accounts, and flexible spending accounts?
J. Why would a business want to be self-insured rather than fully insured?
Part II
A. How would you define healthcare quality?
B. What does the HCAHPS survey purport to do?
C. William Kissick's "Iron Triangle" attempted to define the relationship between three dimensions of healthcare. What are the three dimensions?
D. What are the goals of the Institute for Healthcare Improvement's "Triple Aim"?
E. A 2016 Johns Hopkins University study suggested that deaths attributable to medical errors exceed 250,000 a year. Where would this cause of death rank in the CDC's leading causes of death if it were included as such? (You may have to do a quick search of the CDC's leading causes of death.)
F. What aspects of power among providers, patients, and family members affect healthcare outcomes? What is a sentinel event?
G. According to The Joint Commission, what were the top three sentinel events in 2017?
H. What are "never events"?
I. What percentage of commercial payments to hospitals include a quality component?
J. As of 2017, how many Americans were uninsured?