F- Microeconomics | homework crew
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___________________________ is the lowest price on brand name drugs available from the manufacturer during the rebate period to any entity in the U.S. in any pricing structure.a) 340B Priceb) FULc) Best Priced) ASPWhat benchmark is becoming the gold standard drug reimbursement for drugs administered in doctors’ offices, infusion centers and includes biologics and biosimilars.a) 340B Priceb) FULc) Best Priced) ASPThis pricing methodology is NOT used in pharmacy claims reimbursement. This type of methodology is published by the manufacturer for wholesalers and wholesalers in turn provide drugs close to the same price to pharmacies.a) WACb) MACc) AMPd) AWPThe gold standard in pharmacy reimbursement formulas is this payment methodology which serves as a readily available published benchmark. It is not the price that manufacturers set for drugs. It is often used by payers to set reimbursement to pharmacies and is spelled out in pharmacy contracts.a) WACb) MACc) AMPd) AWPWhich payment methodology is used by PBMs to determine reimbursement to pharmacies for multi-source generic/brand drugs?a) WACb) MACc) AMPd) AWPThe term “covered entity” applies to the __________________ program which is an agreed upon price between the Secretary of the Department of Health and Human Services and manufacturers.a) FULb) 340Bc) Best Priced) ASPWhat payment methodology do pharmacies use to purchase drugs?e) WACf) MACg) AMPh) AWPThis payment methodology was established by Congress as part of OBRA’90. It is the average price paid to the manufacturer for the drug in the U.S. by wholesalers who distribute to retail pharmacies. It is best described as a retrospective calculated price and is proprietary to the government.a) WACb) MACc) AMPd) AWPFrom the managed care perspective, narrow or preferred pharmacy networks help to control cost. From a patient perspective, it may narrow the number of pharmacies a patient can use for their medication to be reimbursed.a) Trueb) FalseThe _________ managed care model requires a designated primary care provider that acts as a gatekeeper who must refer the patient to specialists if needed.a) PPOb) HMOc) POSd) HDHPThis managed care model requires no gatekeeper, means you have your choice of providers without a designated primary care provider. There is a preferred network that you are incentivized to use as opposed to out of network which costs more.a) PPOb) HMOc) POSd) HDHPWhat managed care model requires the patient to pay a low premium and a high deductible that is usually thousands of dollars? You have greater choices of providers but still have a preferred network of providersa) PPOb) HMOc) POSd) HDHP
Which of the following is/are issues in adolescents that make them more vulnerable?a) Sexual orientationb) Community servicec) Violenced) Both A&Ce) All of the aboveWhich of the following is a strategy to care for children?a) Focus on treatment rather than preventionb) Assume children fit criiteria for other children his/her agec) Rely only on the child to gather his/her health informationd) Ensure the child is connected with resources available in the communityA child’s health is influenced by: (select all that apply)a) A child’s genetic makeupb) Socioeconomic factorsc) Environmental exposuresd) Access to foodYou are counseling a child on a new inhaled corticosteroid he/she will be taking for asthma. Which of the following developmental stages would be the MOST appropriate to say the following: “This medication will go into your lungs and make it easier for you to run and play. You’ll take it when you wake up and before you go to bed. If you don’t take it two times a day it won’t work. You need to brush your teeth after using the medication. Work with your mom/dad/caregiver to make sure you take the medication right and remember to take it.”A) Concrete operationalB) Sensory motorC) Formal operationalD) PreoperationalWhich of the following is TRUE?a) Early adolescence is between 14-17 years old when there is a heightened body awareness and preoccupation with rapid physical changesb) Middle adolescence is when there is a major focus on future life goalsc) Late adolescence occurs between 17-21 years old and is when individual friendships usually replace the peer group in importanced) Abstract thinking dominates early adolescence over concrete thinkingAP is a 5-year-old female who was just discharged from the hospital after having a laproscopic apendectomy for perforated appendicitis. She was transitioned from IV piperacillin/tazobactam to oral ciprofloxacin and metronidazole to take at home. Her mother presents the prescriptions to the pharmacy to fill. Which of the following is/are TRUE?(Select all that apply)a) AP’s mother should be shown how to draw up the doses and administer properlyb) The standard medication education sheed dispensed with ciprofloxacin and metronidazole will typically have specific and helpful information for its use in this clincial situationc) Most children will want to know how the medication tastesd) AP’s mother should be instructed that any household spoon is fine to measure out one teaspoonWhat is the emerging healthcare trend in which many health care professionals work together for the good of the patient by communicating effectively among themselves and with the patient?a) Multidisciplinary careb) The Pharmacist-Patient Care Processc) The Perfusionist-Patient Care Processd) Interdisciplinary careWhat is the academic collaborative (of which Lipscomb University College of Pharmacy & Health Sciences is a part) that promotes, encourages, and supports efforts to prepare future health care professionals so they enter the workforce ready for interprofessional collaborative practice to ensure the health of individuals and populations?a) The Joint Commission (TJC)b) The Interprofessional Education Collaborative (IPEC)c) Joint Commission of Pharmacy Practitioners (JCPP)d) Academia-Based CPESN Transformation (ACT)Which of the following are interventions to decrease risks in adolescents?(Select all that apply)a) Educate on the risks involved with substance abuseb) Inquire about school performance routinelyc) Because adolescents are hesitant to give information, ask specific questions that can be answered with yes or nod) Assure confidentialitye) Discuss risks of early-onset sexual behavior including sexually transmitted infectionsWhich of the following is a defining characteristic of a health care professional?a) Providing an essential service that the public needsb) Providing an essential service that the public needsc) Having an established system of licensured) Being able to deliver some or all of the provided services virtuallyWhich of the following is a requirement for licensure as a registered pharmacist in the U.S.? (Select all that apply)a) Completion of an accredited Doctor of Pharmacy (PharmD) programb) Successfully passing the Noorth American Pharmacist Licensure Examination (NAPLEX)c) Successfully “matching” to an accredited residency program through PhORCASd) Successfully passing the Multistate Pharmacy Jurisprudence Exam (MJPE)
Which of the following is considered an example of member cost share as outlined in the plan benefit design?(Select all that apply)a) Deductibleb) Premiumc) Copayd) Co-insuranceWhat does the P&T in P&T Committee stand for?a) Pharmacists and techniciansb) Plans and tacticsc) Pharmacy and therapeuticsd) Pharmacy benefit managers and trade organizationsA generally managed care research-based program, typically two years in length, post-PharmD training program is best described asa) Residencyb) Fellowshipc) Internshipd) Externship__________________ is defined as the use of payment methods and other incentives to encourage high quality patient focused, high value care.a) PQAb) NCQAc) CAHPSd) P4PThe organization that provides report cards for physicians and health plans is __________________.a) PQAb) NCQAc) CAHPSd) P4PEvaluation of drug therapy for known allergies, drug-drug interactions, duplications of therapy, over-/under- dosing, and potentially inappropriate therapy is a medication safety program known asa) Drug utilization reviewb) Fraud, waste, and abuse programc) Network managementd) Formulary management
What model describes our ability to attain a particular outcome is determined by what we believe is within our control or outside of it?a) Social Learning Theoryb) Health Belief Modelc) Transtheoretical Model of Changed) Locus of Control___________________ implies that the patient is actively engaged in decision making for their care. This is more patient-centered than paternalistic.a) Complianceb) AdherenceWhich of the following is most accurate regarding prevention strategies as opposed to treatment strategies?(Select all that apply)a) Employers are placing an increased emphasis on preventionb) Employers are placing a decreased emphasis on preventionc) Consumers are placing an increased emphasis on preventiond) Consumers are placing a decreased emphasis on preventionLife expectancy in the U.S. increased significantly over the 20th century due to which of the following?(Select all that apply)a) Transportationb) Housingc) Public healthd) Hygienee) Nutritionf) Educational systemWhat impact did COVID have on GDP in 2020?a) Increased GDPb) Decreased GDPc) No effect on GDP________________ is defined as pharmacists accept responsibility for drug-use functions and provides those services governed by awareness of, commitment to, the patients’ interests.a) Medication therapy managementb) Patient-centered carec) Pharmaceutical cared) Biomedical model of care
During motivational interviewing, resolving ambivalence best occurs during the precontemplation and contemplation stages of change.a) TRUEb) FALSEWhich of the following factors contribute to national health expenditures growing at a faster rate historically than the gross domestic product in the U.S.?a) Development and adoption of new technologiesb) Americans pay a declining share of health expensesc) Older population living longer with chronic diseased) All of theseWhich of the following has been an economic impact of COVID on the health care system? (Select all that apply)a) Increased burden on health care professionalsb) Interruptions to the supply chainc) Growth in uninsuredd) Job losse) Increased use of the Marketplace or Health Care ExchangeWhich of the following best describes the concept of “moral hazard”?a) A decrease in health care resource utilization based on the religious beliefs of the patientb) A situation in which an individual must consider an alternative that may conflict with their professional standardsc) An undesirable increase in the utilization of services due to the reduced marginal cost of the service to the patientd) None of theseManaged indemnity plans have greater control over medical costs and quality than HMOs.a) TRUEb) FALSEFUL is most similar or closely related to what pricing methodology used by CMS? [ful3]
While you are on your IPPE rotation your preceptor asks you for the latest statistics on prevalence for asthma. You look it up on the National Center for Health Statistics website which is housed under what agencya) HRSAb) AHRQc) CDCd) VA
Which of the following is considered the clinical doctorate degree for nurses?a) RNb) PhDc) CRNAd) DNPOne potential negative effect of third-party insurance coverage in health care is that it may isolate patients from significant costs of care, which may lead them to avoid additional care that may be needed.a) TRUEb) FALSEIn order to evaluate progress toward one of the Healthy People 2030 goals, you should look at measures of:a) Disparitiesb) Health-related quality of lifec) General health statusd) Determinants of healthe) All of the aboveWhen investigating diabetes data for you Practice Seminar presentation which of the following sources includes diabetes data?a) NHANESb) BRFSSc) NHISd) All of the aboveWhat is the leading cause of death in the United States?a) COVIDb) Diabetesc) Cardiovascular diseased) Cancere) Suicide
The piece of legislation passed by Congress that regulates the building of new hospitals is called?a) Affordable Care Actb) OBRA ’90c) HIPAAd) Hill-BurtonWhat time period in American history saw the development and passage of Medicare and Medicaid?a) 1950sb) 1960sc) 1970sd) 1980sWhich of the following is an example of the role of patients as consumers of health care? (select all that apply)a) Self-health careb) Use of the internet to find health informationc) Relying on the provider to tell them what to dod) Ask their provider about direct-to-consumer advertising they saw on social mediaWhich of the following is NOT true regarding the U.S. Public Health Service?a) Is an independent agency of the Centers for Disease Control (CDC)b) Charged with protecting health and providing essential health servicesc) Includes the Bureaus of Prisonsd) Pharmacists serve in a variety of agencies within the U.S. Public Health ServiceThe limitation or reduction of disability when disease has already occurred through rehabilitation is the definition for:a) Primary preventionb) Secondary preventionc) Tertiary preventiond) Quaternary preventionThe rate of new cases occurring in a population over a specific period of time is the definition for?a) Prevalenceb) Point prevalencec) Incidenced) Epidemiology
Which of the following plays a role in the public health system?a) The communityb) The mediac) Employersd) Academiae) All of the aboveA state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity is the definition for:a) Healthb) illnessLife expectancy, self-assessed health status, and limitation of activity are what type of health status measures?a) General health status measuresb) Health-related quality of life and well-being measuresc) Disparities measuresd) Determinants measuresAge, gender, and race/ethnicity are what type of health status measures?a) General health status measuresb) Disparities measuresc) Determinants measuresd) Health-related quality of lifeWhat agency is responsible for improving access to health care services for uninsured, isolated, and medically vulnerable patients?a) AHRQb) CDCc) HRSAd) NIHWhat level of government is responsible for issuing licenses to health care professionals?a) Localb) Statec) Regionald) FederalOf the departments listed below which department in the Federal government has the greatest impact on health care?a) IRSb) Treasury Departmentc) HHSd) State DepartmentWhat agency is responsible for creation and dissemination of knowledge that enhances quality, appropriateness, and effectiveness of health care?a) AHRQb) NIHc) CDCd) HRSA
Which center within CMS is primarily responsible for combating fraud, waste, and abuse in health care?a) Medicareb) Medicaidc) Innovation Centerd) Program Integrity_______________ refers to differences between groups in health coverage, access to care, and quality of care.a) Health disparityb) Health care disparityc) Cultural competencyd) Paradoxes in careIn the beginning Blue Cross was developed to cover doctors’ fees and Blue Shield was developed to cover hospital fees.a) TRUEb) FALSEIn the COVID epidemic the sentinel case was determined to originate from Wuhan, China. During an outbreak the sentinel case is best defined as:a) The last case to end an outbreakb) The first case of an outbreakc) The typical case seen during an outbreakd) The worst case example experienced during an outbreakWhen we think of the leading causes of death, COVID has become one of the top 3 leading causes of death in the U.S.a) TRUEb) FALSEWhat two pieces of legislation produced the greatest expenditures related to COVID? (select all that apply)a) Paycheck Protection Program & Health Care Enhancement Act of 2020b) Families First Coronavirus Response Act of 2020c) Provider Relief Fundd) Coronavirus Response & Relief Supplemental Appropriations Act of 2021
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