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Module 1: Navigating US Healthcare System

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Welcome: Navigating US Healthcare System

1 Quiz
- 1.1 Navigating Healthcare
Bonus: History of Health Insurance in US
Important Players

1 Quiz
- 1.2 Important Players
How We Pay for Healthcare: Insurance Plans

1 Quiz
- 1.3 Insurance Plans
Health Insurance Terms

1 Quiz
- 1.4 Health Insurance Terms
Bonus: Health Savings Accounts & Flexible Spending Accounts
Medicare

1 Quiz
- 1.5 Medicare
Reimbursement Types

1 Quiz
- 1.6 Reimbursement Types
Quality Measures

1 Quiz
- 1.7 Quality Measures

Quiz 6 of 7

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1.6 Reimbursement Types

Module 1: Navigating US Healthcare System Reimbursement Types 1.6 Reimbursement Types

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Question 1 of 5

1. Question
Which type of care model has been historically the primary payment model and incentivized a more reactive care approach?
- Value-based care
- Capitated payment model
- Bundled payment model
- Volume-based care
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Question 2 of 5

2. Question
Volume-based care incentivises a higher _________ of care vs value-based care incentivises a higher ___________ of care.
- quality, quantity
- quantity, quality
- co-pay, co-insurance
- use of lab tests, use of electronic medical records
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Question 3 of 5

3. Question
Why did the Centers for Medicare & Medicaid Services (CMS) aim to phase out fee-for-service plans?
- They were not profitable for providers.
- They did not provide adequate coverage for patients.
- They incentivized over-utilization of services.
- They were too complicated for consumers to understand.
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Question 4 of 5

4. Question
How are providers reimbursed for services under a capitated payment model?
- Providers receive a monthly payment per patient to cover all care needs.
- Providers receive payment for each individual service provided.
- Providers are paid a specific amount per service provided.
- Providers are paid based on the total number of patients seen each month.
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Question 5 of 5

5. Question
How are providers reimbursed for services under a bundled payment model?
- Providers are paid a specific amount per service provided.
- Providers are paid based on the total number of patients seen each month.
- Providers are paid at the beginning of the physical year.
- Providers receive one lump sum payment for all of the patient's care in a care episode.
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1.6 Reimbursement Types

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