HCM 520 Exam

Question 1 (2 points)

Beginning in 2013, the Centers for Medicare and Medicaid Services began to release certain Medicare provider charge data for public viewing. The purpose of this action is primarily to increase which of the following in the U.S. health care system?
Question 1 options:
Question 2 (2 points)
Which of the following are associated with public health, as opposed to health care? Select all that apply.
Question 2 options:
Making sure water supplies are safe
Protecting the environment
Restoring health once an illness has occurred
Ensuring that a community has a safe place for people to be physically active
Keeping people healthy

Question 3 (2 points)

Which of the following sources of health care funding has decreased significantly from its level in 1970 to its level in 2012?
Question 3 options:
Private health insurance
Out of pocket
Question 4 (2 points)
According to the University of Wisconsin Population Health Institute, what percentage of ultimate health outcomes are determined primarily by personal health behaviors?
Question 4 options:
Question 5 (2 points)
Which stakeholder in the U.S. health care system is most likely to view the cost of health insurance as a cost of doing business and a major factor affecting profitability?
Question 5 options:
Public policy makers
Question 6 (2 points)
Which of the following are defining characteristics of the U.S. health care system? Select all that apply.
Question 6 options:
The dominant role of politicians in running the system
Dysfunctional financing and payment
Outdated technology and lack of new drugs
Tension between the free market and government control
Question 7 (2 points)
Which of the following is the primary desire of consumers as stakeholders in the U.S. health care system?
Question 7 options:
Productivity in the workplace
Social goal of keeping people healthy
Lower costs for health care services
Access to affordable and quality health care

Question 8 (2 points)

In the United States, access to medical care and its associated outcomes depend on which of the following characteristics of the individual? Select all that apply.
Question 8 options:
Medical need
Geographical location
Income level

Question 9 (2 points)

Which U.S. President was instrumental in establishing Medicare and Medicaid as part of his vision for a “Great Society”?
Question 9 options:
Barrack Obama
Lyndon B. Johnson
John F. Kennedy
Harry Truman
Question 10 (2 points)
A Supreme Court decision in 2012 accomplished which of the following related to the Affordable Care Act?
Question 10 options:
Rendered state participation in Medicaid expansion voluntary
Required the law to extend coverage of dependents to those up to 30 years old
Found the individual mandate to be unconstitutional
Disallowed the provision that prevented insurers from denying coverage due to applicants with preexisting conditions
Question 11 (2 points)
Which of the following are initiatives contained in the Affordable Care Act? Select all that apply.
Question 11 options:
Those with private insurance plans are required to drop them and obtain insurance through a government exchange
Nearly all Americans are required to have some form of health insurance or pay a penalty through the tax code
Those with private insurance will have to change doctors
Each state will be encouraged to create an insurance exchange, through which the uninsured will be able to purchase more affordable private coverage
Employers with more than 50 full-time employees will be required to provide coverage to employees or pay a penalty

Qestion 12 (2 points)

In the 19th century, most Americans received health care in what setting?
Question 12 options:
Physician offices
Question 13 (2 points)
Which U.S. federal organization is specifically responsible for reporting on progress made toward improved health care quality and opportunities for ongoing improvement?
Question 13 options:
National Institutes of Health
Agency for Healthcare Research and Quality
Centers for Disease Control and Prevention
Food and Drug Administration

Question 14 (2 points)

Which federal program is a collection of 50 state-administered programs, each providing health insurance to low-income state residents, but with differing eligibility rules, benefits, and payment schedules?
Question 14 options:
Affordable Care Act
Question 15 (2 points)
Public hospitals and health clinics in the U.S. are primarily owned and operated by which of the following?
Question 15 options:
State governments
Federal government
Local governments
Non-profit charities
Question 16 (2 points)
Advocates for pediatricians and children are most likely to be key players in which policy subsystem?
Question 16 options:
Veterans Health Administration


Question 17 (2 points)
The U.S.’s health system can best be described by which of the following?
Question 17 options:
A patchwork of public and private insurance system
A socialized medicine system
A national health system
A national health insurance system
Question 18 (2 points)
A correlation in which there is a steady, predictable change in an outcome that corresponds to a steady change in a factor is which of the following?
Question 18 options:
Reverse causality
Integrative model
Question 19 (2 points)
Which model homes in on individuals and focuses on the factors that are most immediately linked to the pathophysiology of a person’s disease?
Question 19 options:
Integrative model
Population health model
Medical model
Multiple determinants model
Question 20 (2 points)
Which criteria for payment of health care typically results in wealthier, younger, and healthier individuals paying disproportionately to finance the care of poorer, older, and sicker individuals?
Question 20 options:
Ability-to-pay criteria
Estimated risk
Random selection
Actuarial principles

Question 21 (2 points)

Which of the following countries rely to varying degrees on subnational and local governments to finance health care? Select all that apply.
Question 21 options:
United Kingdom
United States
Question 22 (2 points)
Which of the following countries have national health insurance systems, which are modelled after the one designed by Bismarck? Select all that apply.
Question 22 options:
United States
Question 23 (2 points)
The fact that an individual smokes would be classified as which type of determinant of health?
Question 23 options:
Health-related behavior
Social and economic environment
Physical environment
Medical care
Question 24 (2 points)
By the end of 2013, about half of physician payments to health care providers in China came from which of the following?
Question 24 options:
Straight salary
Combination of capitation payment and fee-for-service
Capitation payment

Question 25 (2 points)

According to Trust for America’s Health, an investment of $10 per person per year in proven community-based programs to increase physical activity, improve nutrition, and prevent smoking and other tobacco use could save the country more than $16 billion annually; this would produce what return for every $1 invested?
Question 25 options:
Question 26 (2 points)
A program that seeks to educate children and their parents on the importance of wearing helmets while bicycling is an example of which of the following?
Question 26 options:
Tertiary prevention
Health promotion
Primary prevention
Secondary prevention
Question 27 (2 points)
According to the 2010 County Health Rankings Model, which category of health determinants had the greatest impact on health outcomes?
Question 27 options:
Social and economic factors
Clinical care
Health behaviors
Physical environment
Question 28 (2 points)
What proportion of total U.S. expenditure on health is spent on diseases that are preventable?
Question 28 options:
Two thirds
One third
One fourth
One half
Question 29 (2 points)
Which of the following essential public health services would be considered related to policy development? Select all that apply.
Question 29 options:
Inform, educate, and empower people about health issues.
Enforce laws and regulations that protect health and ensure safety.
Monitor health status to identify community health problems.
Develop policies and plans that support individual and community health efforts.
Mobilize community partnerships to identify and solve health problems.
Question 30 (2 points)
Imagine that you have been placed on a county committee in your home state to make decisions on how to most effectively invest in changes that will improve the overall health of residents of the county. Which of the following would likely be the most effective measure, based on the 2010 County Health Rankings Model?
Question 30 options:
Purchasing a new x-ray machine for the local hospital
Establishing awareness of air quality and its effect on health
Beginning a smoking cessation program
Adding several nurses to the staff of the local health clinic
Question 31 (2 points)
Which of the following are true of public health institutes? Select all that apply.
Question 31 options:
Can advocate for public health programs and funding
May accept private funds
Offer a credible, neutral, third-party voice
Part of state governments
Question 32 (2 points)
Which of the following is a public health, rather than a health care, intervention?
Question 32 options:
Teaching a free seminar at a community health clinic on heart-healthy cooking
Performing balloon angioplasty on a patient with an occluded major artery
Counseling a patient at risk for stroke on signs and symptoms of impending stroke
Taking an EKG of a cardiac patient

Question 33 (2 points)

In 2011, what percentage of adults engaged in at least 75 minutes per week of moderate-to-vigorous aerobic exercise, a proportion that meets Healthy People 2020 guidelines for recommended physical activity among adults?
Question 33 options:
Question 34 (2 points)
Which of the following are factors that have contributed to the growing number of vulnerable populations? Select all that apply.
Question 34 options:
Rise in the number of HIV infections each year
Aging of the Baby Boomers
Increased prevalence of chronic conditions
Reduction in supportive services in low-income communities
Increase in violent crimes

Question 35 (2 points)

An older Hispanic woman has diabetes mellitus and lacks health insurance. Which factor is an example of a health need?
Question 35 options:
Older age
Hispanic ethnicity
Lack of insurance
Diabetes mellitus
Question 36 (2 points)
Which of the following is the best example of a social health need?
Question 36 options:
Bipolar disorder
Question 37 (2 points)
Which model of health behavior change integrates behavioral science with clinical and public health approaches and defines the targets of successful health interventions to be not only individuals but also the powerful social contexts in which the individuals live and work?
Question 37 options:
5 A’s
Social ecological
Social marketing
Question 38 (2 points)
Approximately what percentage of American adults are either overweight or obese?
Question 38 options:
Question 39 (2 points)
A neighbor of yours is pregnant and struggles financially to afford healthy food. Which of the following social service programs would be most appropriate to refer her to?
Question 39 options:
Supplemental Security Income
Women, Infants, and Children
Supplemental Nutrition Assistance Program
Temporary Assistance for Needy Families
Question 40 (2 points)
Which of the following are examples of “midstream” interventions for behavior change? Select all that apply.
Question 40 options:
Pharmacologic treatments
Worksite seminar on cholesterol
Excise taxes on tobacco products
Nutrition promotion at a local elementary school
Group and individual counseling

Question 41 (4 points)

What makes the health care system so important to life in the United States?
Question 41 options:

Question 42 (4 points)

How does the U.S. compare with other countries in terms of access to services across income groups?
Question 42 options:

Question 43 (4 points)

What are Health Impact Assessments (HIAs) used for?
Question 43 options:

Question 44 (4 points)

What is a vulnerable population? What factors lead someone to be categorized as vulnerable?
Question 44 options:
Question 45 (4 points)
Discuss some of the environmental and economic changes affecting behavior on both sides of the energy balance question that have contributed to the dramatic rise in the prevalence of overweight and obesity among youth and adults over the past several decades.