UHC MODULE 7 POST TEST
Question 1
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The three main functions of an effective health financing system:
a.
revenue generation, pooling, strategic purchasing
b.
prospective payment, network-based payment, frontloading
c.
All Case Rates, Diagnosis-Related Groups, Global Budget
d.
capitation, fee-for-service, case-based
e.
None of the above
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The correct answer is:
revenue generation, pooling, strategic purchasing
Question 2
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The following correctly differentiates No Balance Billing policy from No Co-Payment
policy:
a.
The No Balance Billing policy is based on the mandate of the UHC Act whereas the No
Co-Payment policy is based on the IRR of the National Health Insurance Act.
b.
The No Balance Billing policy covers all membership categories of PhilHealth whereas
the No Co-Payment policy covers only the indirect contributors.
c.
The No Balance Billing policy is based on membership categories whereas the No Co-
Payment policy is based on the hospital accommodation type.
d.
All of the above are correct.
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The correct answer is:
The No Balance Billing policy is based on membership categories whereas the No Co-
Payment policy is based on the hospital accommodation type.
Question 3
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The following serve as the bases of the Provincial and City Health Board for the planning
and budgeting of the Special Health Fund:
a.
Local Investment Plan for Health and its corresponding Annual Operational Plans
b.
Contractual agreements with DOH and PhilHealth
c.
Municipal, city, and provincial resolutions on health strategies
d.
All of the above are correct.
e.
Only A and B are correct.
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The correct answer is:
Only A and B are correct.
Question 4
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The agency responsible to develop monitoring tools to track the implementation of the
No Co-Payment Policy:
a.
Commission on Audit
b.
Local Government Unit
c.
Department of Health
d.
Philippine Health Insurance Corporation
e.
All of the above
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The correct answer is:
Philippine Health Insurance Corporation
Question 5
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Method of paying health care providers based on bundling together sets of health
services and resources into single payment amounts:
a.
Capitation
b.
Case-based payments
c.
Global Budget
d.
Fee-for-service
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The correct answer is:
Case-based payments
Question 6
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The following are the allowable expenses for the Special Health Fund, EXCEPT:
a.
Incentives for all health workers
b.
Remuneration of all health workers
c.
Health system operating costs
d.
Individual-based health services
e.
Population-based health services
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The correct answer is:
Remuneration of all health workers
Question 7
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The general term for the way PhilHealth will pay health care providers for services
delivered to the covered population:
a.
All Case Rates Method
b.
Diagnosis-Related Groups
c.
Provider-Payment Mechanism
d.
Global Budget
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The correct answer is:
Provider-Payment Mechanism
Question 8
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The provision of regular meal, bed in shared room, fan ventilation, and shared toilet and
bath during hospital confinement:
a.
Non-basic accommodation
b.
Basic accommodation
c.
Fringe accommodation
d.
Suite room accommodation
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The correct answer is:
Basic accommodation
Question 9
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The following member categories are covered by the current No Balance Billing (NBB)
policy, EXCEPT:
a.
Lifetime member
b.
Sponsored member
c.
Indigent member
d.
Individual paying member
e.
Kasambahay
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The correct answer is:
Individual paying member
Question 10
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Which of the following statements is incorrect?
a.
The Joint Memorandum Circular on Special Health Fund provided the minimum fund
level that will be allocated for equity purposes.
b.
The Provincial/City Health Board Resolution on the Special Health Fund budget shall be
deliberated, endorsed and approved by the Chairperson, Vice-Chairperson and a
majority of the members of the Board.
c.
The authorized signing officials for the disbursement of funds shall be based on RA No.
7160 (Local Government Code) and RA No. 11223 (Universal Health Care Act).
d.
All statements are correct.
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The correct answer is:
The Joint Memorandum Circular on Special Health Fund provided the minimum fund
level that will be allocated for equity purposes.
Question 11
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The flat fee or predetermined rate paid at the point-of-service:
a.
Co-payment
b.
Cost-sharing
c.
Health benefit coverage
d.
Co-insurance
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The correct answer is:
Co-payment
Question 12
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The Special Health Fund shall be maintained at the following LGU levels that committed
to integrate, EXCEPT:
a.
Component Cities
b.
Provinces
c.
Highly Urbanized Cities
d.
Independent Component Cities
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The correct answer is:
Component Cities
Question 13
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The following reflects the major steps in the management of the Special Health Fund:
a.
creation; planning and budgeting; disbursement and utilization; monitoring,
transparency and accountability
b.
call for P/CWHS to open SHF depository bank account; contract negotiation;
authorization and approval of SHF budget; submission of utilization report
c.
organization of the P/CHB and its support units; signing of contracts with stakeholders;
disbursement and utilization; budget accountability
d.
None of the above
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The correct answer is:
creation; planning and budgeting; disbursement and utilization; monitoring,
transparency and accountability
Question 14
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Method of paying health care providers based on classifying cases into a group with the
same characteristics in terms of diagnoses, procedures, and expected resource use:
a.
Diagnosis-related groups
b.
Global Budget
c.
Case-based payments
d.
Fee-for-service
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The correct answer is:
Diagnosis-related groups
Question 15
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The provision of minimum standards of care for patients including fringe or additional
amenities at the option of the patient during hospital confinement:
a.
Suite room accommodation
b.
Basic accommodation
c.
Fringe accommodation
d.
Non-basic accommodation
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The correct answer is:
Non-basic accommodation
Question 16
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The following document is the primary basis for the transfer of funds from DOH to the
LGU:
a.
Memorandum of Understanding
b.
Sub-Allotment Guidelines
c.
Administrative Order
d.
Terms of Partnership
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The correct answer is:
Terms of Partnership
Question 17
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The least effective method of paying health care providers in terms of driving efficiency,
as this motivates providers to over-provide services:
a.
Capitation
b.
Fee-for-service
c.
Global Budget
d.
Case-based payments
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The correct answer is:
Fee-for-service
Question 18
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The management of the Special Health Fund is being monitored through the Local
Health Systems Maturity Levels under the following P/CWHS characteristic:
a.
Information Management
b.
Strategic and Investment Planning
c.
Financial Management
d.
Unified Governance of the Local Health Systems
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The correct answer is:
Financial Management
Question 19
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A patient who opt for non-basic accommodation is charged a form of co-payment for
hospital services, professional fees, and fringe or additional amenities. The following are
considered as examples of fringe or additional amenities:
a.
Air-conditioning
b.
Regular meals
c.
Telephone
d.
Common bathrooms
e.
Only A and C are correct.
f.
Only A, B and C are correct.
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The correct answer is:
Only A and C are correct.
Question 20
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The direct payment of a portion of health care costs by an insured person when
receiving health services:
a.
Health benefit coverage
b.
Co-payment
c.
Co-insurance
d.
Cost-sharing
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The correct answer is:
Cost-sharing
Question 21
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All health care providers shall comply with the prescribed allocation of basic and non-
basic accommodation within their facilities. Which of the following bed ratios stated in
the Universal Health Care Act is correct?
a.
All government hospitals shall allocate at least 90% of their approved bed capacity to
non-basic accommodation.
b.
All government specialty hospitals shall allocate at least 90% of their approved bed
capacity to basic accommodation.
c.
All private hospitals shall allocate 70% of their approved bed capacity to non-basic
accommodation.
d.
All private hospitals shall allocate 10% of their approved bed capacity to basic
accommodation.
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The correct answer is:
All private hospitals shall allocate 10% of their approved bed capacity to basic
accommodation.
Question 22
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Method of paying health care providers based on a lump sum amount paid prior to an
agreed-upon time period:
a.
Fee-for-service
b.
Global Budget
c.
Capitation
d.
Case-based payments
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The correct answer is:
Global Budget
Question 23
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The following are the possible sources of funds for the Special Health Fund:
a.
Financial grants from the national government
b.
LGU budget for health
c.
Revenues from PhilHealth payments
d.
All of the above are correct.
e.
Only A and C are correct.
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The correct answer is:
All of the above are correct.
Question 24
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The implementation of the Global Budget by PhilHealth will be based on the following:
a.
Diagnosis-related groups for inpatient hospital services
b.
Capitation scheme for primary care services
c.
Fee-for-service scheme for private health care providers
d.
All-case rates method for individual-based health packages
e.
Only A and B are correct.
f.
Only A, B and C are correct.
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The correct answer is:
Only A and B are correct.
Question 25
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Method of paying health care providers based on the number of people within their
catchment area:
a.
Case-based payments
b.
Fee-for-service
c.
Capitation
d.
Global Budget
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The correct answer is:
Capitation
Question 26
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The appropriation of the budget from the following LGU fund requires an ordinance
passed by the Sanggunian:
a.
General Fund
b.
Trust Fund
c.
Special Health Fund
d.
Special Fund
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The correct answer is:
General Fund
Question 27
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PhilHealth’s current provider-payment mechanism:
a.
All Case Rates Method
b.
Global Budget
c.
Diagnosis-Related Groups
d.
Provider Payment Mechanism
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The correct answer is:
All Case Rates Method
Question 28
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The No Co-Payment policy will remain in effect in the provision of the following
PhilHealth benefit packages during the transition period of shifting from No Balance
Billing policy to No Co-payment policy:
a.
All case rates and Primary Care Benefits
b.
All case rates and Z Benefits
c.
Z Benefits and COVID-19 benefits
d.
Z Benefits and Primary Care Benefits
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The correct answer is:
Z Benefits and COVID-19 benefits
Question 29
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The number assigned to each DRG that reflects resource intensity based on collected
cost data:
a.
DRG rate
b.
Adjustment Factor
c.
Base rate
d.
Relative Weight (RW)
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The correct answer is:
Relative Weight (RW)
Question 30
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This entity has the full responsibility in the management of the Special Health Fund:
a.
Local Chief Executive
b.
Provincial/City Health Board
c.
Sanggunian Panlalawigan/ Panlunsod
d.
Provincial/ City Budget Officer
e.
All of the above
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The correct answer is:
Provincial/City Health Board
