Final Exam:
The final exam is a take home exam. The exam is due Friday, May 10 at 1:00 PM. You may turn in hard copies of your exam to me at my office on Friday between 10:00 AM and 1:00 PM or email them to me by Friday. Feel free to contact me by email if you have any questions or issues.
Instructions:
For this exam, you will be reading two recent blog posts from health affairs and answering questions from and/or related to the readings. The exam is in principle cumulative, but most of the required material will come from the second half of the semester. Read all of the questions from the exam before doing the reading. In particular, it will be easier if you read the post while taking notes with an eye towards answering the different questions in the test. The questions are asked to roughly match where the topic appears in the post, although the questions will require you to refer to lectures and readings from class. I expect the exam to take less than 5 hours and hopefully between 1 and 3 hours. The exam is worth 100 points and has 2 parts of 6 and 14 questions respectively. Each response is worth 5 points. Each question includes an estimate of how long your response should be in number of sentences. I will give a total of 5 extra credit points if you do not significantly overshoot or undershoot that length on any question (within one sentence of the suggested length). So ideal responses will be clear, complete, and concise. Do not share your answers or discuss answers with classmates and ensure that your answer represent your own work without the help or input of others.
Part 1:
Read:
Nathan Handley, Judd E. Hollander Opportunity Cost: The Hidden Toll Of Seeking Health Care, Health Affairs Blog, May 1, 2019.
Answer:
1) Define cost-sharing, copay, coinsurance, deductible, and out-of-pocket maximum. (5 sentence)
2) Define opportunity cost based on the reading (1 sentence) and explain how opportunity cost complicates the cost of care in the example at the beginning of the reading (3 to 6 sentences).
3) In the section, “Quality and Cost”, what are 4 measures of quality discussed (not including LOS). What is an advantage and disadvantage of each as a measure of quality? (4 to 8 sentences).
4) What does LOS stand for? In your opinion, is this a good measure of quality? (2 to 4 sentences)
5) What are three patient care proposals that are not yet reimbursed by CMS? (1 sentence)
6) What do APM and VBP stand for? What is their primary goal? (1 to 2 sentences)
Part 2:
Read:
John C. Goodman, Lawrence J. Wedekind, How The Trump Administration Is Reforming Medicare, Health Affairs Blog, May 3, 2019.
Answer:
1) Define ACOs (1 sentence)
2) Define the three main parts of Medicare: A, B, and D. What part is Medicare Advantage (A, B, C, or D)? (4 sentences)
3) What is HIPAA and why might it apply to the section, “ACOs Versus MA Plans”? (2 to 4 sentences)
4) What is the difference between reimbursement based on FFS and capitation? (3 to 6 sentences)
5) According to the post, why are incentives for quality improvement weaker in the ACO system vs MA plans? (3 to 6 sentences)
6) Define risk adjustment and upcoding. (2 to 4 sentences)
7) How, in the authors’ opinions, are ACOs stealth privatization? (2 to 4 sentences)
8) This paper focuses on Private provision of Medicare through MA. What is private provision of Medicaid called? (1 sentence)
9) According to the post, “At last count, there were 32.7 million patients enrolled in ACOs. This includes 10.4 million Medicare beneficiaries”. According to CMS’ Medicare Beneficiaries at a Glance, how many people are enrolled in Medicare and how many are enrolled in Medicare Advantage? (1 sentence)
10) What does dual eligible mean? According to CMS’ Medicare Beneficiaries at a Glance, how many people are dual eligible? (1 to 2 sentences)
11) The paper suggests ACOs have not been successful. Were ACOs included in Mendelson et al. 2017’s systematic review (see section titled, “Study Selection”)? Why or why not? (1 to 2 sentences)
12) According to Mendelson et al. 2017’s systematic review, were other P4P programs successful? (1 to 2 sentences)
13) Based on this reading and our class discussion, what are the main principles of Republican health reform plans including Trump’s policies? Based on this reading and our class discussion, what are the main principles of Democratic health reform plans including Obama’s policies? (2 to 4 sentences)
14) What were four ways in which the Affordable Care Act led to lower rates of uninsurance? (1 to 2 sentences)
Again, feel free to contact me by email if you have any questions or issues.