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Quiz

Chapter 7

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  1. 1Price setters vs price takers. When a provider has market dominance, and hence can set its own prices, it is said to be a _____?
    1. Aprice setter
    2. Bprice taker
  2. 2Providers are ___?
    Perfectly competitive markets
    Payer dominance
    Government programs
    1. Aprice taker
    2. Bprice setter
  3. 3When a provider is a price setter there are two most common theoretical bases
    1. Afull cost pricing and marginal cost pricing
    2. Blow pricing and no marginal cost pricing
  4. 4Full cost pricing, prices for a service are set to cover all costs: (3)
    1. Adirect variable costs
    2. Bindirect overhead costs
    3. Cdirect fixed costs
    4. Dno fixed costs
  5. 5Price takers uses
    1. Aproject costing
    2. Btarget costing
  6. 6Scenario Analysis, to break even, revenues must
    1. Aequal net profit
    2. Bequal total costs
  7. 7total costs = ___ + ____
    1. Atotal cost = total mc + total fc
    2. Btotal cost = total visits + total vc
    3. Ctotal costs = total variable costs + total fixed cost
  8. 8the value of scenario analysis,

    focused on:
    1. AIt is obvious that scenario analysis gives decision makers more insights into the decision at hand.
    2. BThe minimum PMPM rate necessary to break even.
    3. CThe maximum PMPM rate necessary to break even.
    4. DThe ability to accept a lower PMPM rate when cost control is possible.
    5. EThe ability to accept a higher PMPM rate when cost control is possible.
  9. 9Setting Managed Care Plan Rates,
    1. AManaged care plans must not set the rates they charge to employers on the basis of their costs of providing healthcare services.
    2. BManaged care plans must set the rates they charge to employers on the basis of their costs of providing healthcare services.
    3. Cthe rates for different services are estimated and then aggregated.
    4. Dthe rates for same services are estimated and then aggregated.
    5. EThis is usually done on a PMPM basis regardless of the actual reimbursement methods used to pay providers.
    6. FThis is usually done with something else besides PMPM basis regardless of the actual reimbursement methods used to pay providers.
  10. 10Setting Managed Care Plan Rates (Cont.),
    There are three techniques used to set the rates for individual providers:
    1. AFee-for-service (FFS) approach
    2. BFace-to-face approach
    3. CRandom approach
    4. DCost approach
    5. EDemographic approach
    6. FEthnicity approach

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