C812 HIM 4610 Healthcare Reimbursement OA READINESS EXAM Q & S 2025/2026

1. Which reimbursement model involves a single payment
for all services provided during an episode of care?
 - a) Fee-for-service
 - b) Capitation
 - c) Bundled payments
 - d) Pay-for-performance
 Answer: c) Bundled payments
 Rationale: Bundled payments are designed to promote
quality and cost efficiency by providing a single payment for
all services provided during an episode of care, as opposed
to paying separately for each service.
2. What is the primary focus of the value-based care
model?
 - a) Increasing the volume of services
 - b) Reducing administrative costs
 - c) Improving patient outcomes while controlling costs
 - d) Expanding insurance coverage
 Answer: c) Improving patient outcomes while controlling
costs
 Rationale: Value-based care is centered on improving
patient health outcomes and reducing healthcare costs,
contrasting with traditional fee-for-service models.
3. Which of the following is a key feature of the DiagnosisRelated Groups (DRG) system?
 - a) Payment solely based on the quantity of care
 - b) Payment rates are adjusted based on patient
outcomes
 - c) Classification of hospital cases into groups for
reimbursement