AHM-510 Governance and Regulation |
AHIP Academy for Healthcare
Management Certification Practice
Exam | 2026/2027 | With Questions
and Correct Answers | Complete
Practice Exam Material | Guaranteed
pass | Brand New Version!!!!!
Which statement is true about the regulation of health plans?
a. Health plans are no more regulated than most other industries
b. Only a few aspects of health plans are subject to regulation
c. Laws have been both narrowly focused and broad in scope
d. Health plans are regulated at the federal but not the state level - CORRECT ANSWER c. Laws
have been both narrowly focused and broad in scope
Which statement is true about public policy and health plans?
a. Public policy can create opportunities for plans as well as restrictions
b. Public policy restricts actions and practices but does not normally impose costs
,c. The ACA has caused plans to focus exclusively on medical insurance
d. Because laws are clarified in regulations, court decisions have had little impact - CORRECT
ANSWER a. Public policy can create opportunities for plans as well as restrictions
Which statement is true about the health plan environment?
a. Healthcare is largely unaffected by the ups and downs of the overall economy
b. The health plan market has shifted from mostly national to mostly local
c. Enrollment has increased since the enactment of the ACA
d. More people eligible for Medicare means fewer opportunities for health plans - CORRECT
ANSWER c. Enrollment has increased since the enactment of the ACA
A large metropolitan area has strong competition among several health plans and sophisticated
employers, consumers, and providers. This describes a...
a. Consolidated market
b. Mature market
c. Immature market
d. Undeveloped market - CORRECT ANSWER b. Mature market
Select one of the options below to complete the sentence. Consolidation (mergers and
acquisitions) in health plans...
a. Has declined in recent years
b. Increases efficiency and entails few costs
c. Has been driven in part by the ACA
d. Has not been matched by consolidation among providers - CORRECT ANSWER c. Has been
driven in part by the ACA
Some health plans have modified their designs to address the desire of members and potential
members for greater choice in providers. This is an example of the power of
,a. Consumers
b. Purchasers
c. Providers
d. Payers - CORRECT ANSWER a. Consumers
To prove that employers' dollars are being well spent, health plans have devoted time and
money to outcomes research and other quality-ensuring initiatives. This is an example of the
power of
a. Consumers
b. Purchasers
c. Providers
d. Payers - CORRECT ANSWER b. Purchasers
New compensation methods, such as bundled payments and value-based payment models,
designed to enhance provider accountability, are an example of the power of
a. Consumers
b. Purchasers
c. Providers
d. Payers - CORRECT ANSWER d. Payers
Taking an active role in the community is
a. Common only for not-for-profit health plans
b. The right thing to do but brings a health plan no real benefits
c. Advisable for health plans, regional and national as well as locally focused
d. Legally required for all health plans - CORRECT ANSWER c. Advisable for health plans,
regional and national as well as locally focused
, ®Those with limited access to healthcare services are most commonly
a. The elderly
b. Rural people and low-income urban people
c. Residents of large cities of all income levels
d. Residents of suburban areas of all income levels - CORRECT ANSWER b. Rural people and low-
income urban people
Which statement is true about stakeholders in the health plan environment
a. Health plans may not act as vendors to self-insured employers
b. Academic medical centers have been largely insulated from changes in the environment
c. Health plans often collaborate with patient advocacy groups
d. State and federal governments are purchasers and payers as well as regulators. - CORRECT
ANSWER c. Health plans often collaborate with patient advocacy groups
The owner or owners have full responsibility for the debts of the business. This is true for...
a. Neither a sole proprietor, general partners, nor limited partners
b. A sole proprietor but not a general or limited partners
c. A sole proprietor and general partners, but not limited partners
d. A sole proprietor, general partners, and limited partners - CORRECT ANSWER c. A sole
proprietor and general partners, but not limited partners
Who can be involved in managing the day-to-day operations of a business?
a. Neither a sole proprietor, general partners, nor limited partners
b. A sole proprietor but not a general or limited partners
c. A sole proprietor and general partners, but not limited partners
d. A sole proprietor, general partners, and limited partners - CORRECT ANSWER c. A sole
proprietor and general partners, but not limited partners
AHIP Academy for Healthcare
Management Certification Practice
Exam | 2026/2027 | With Questions
and Correct Answers | Complete
Practice Exam Material | Guaranteed
pass | Brand New Version!!!!!
Which statement is true about the regulation of health plans?
a. Health plans are no more regulated than most other industries
b. Only a few aspects of health plans are subject to regulation
c. Laws have been both narrowly focused and broad in scope
d. Health plans are regulated at the federal but not the state level - CORRECT ANSWER c. Laws
have been both narrowly focused and broad in scope
Which statement is true about public policy and health plans?
a. Public policy can create opportunities for plans as well as restrictions
b. Public policy restricts actions and practices but does not normally impose costs
,c. The ACA has caused plans to focus exclusively on medical insurance
d. Because laws are clarified in regulations, court decisions have had little impact - CORRECT
ANSWER a. Public policy can create opportunities for plans as well as restrictions
Which statement is true about the health plan environment?
a. Healthcare is largely unaffected by the ups and downs of the overall economy
b. The health plan market has shifted from mostly national to mostly local
c. Enrollment has increased since the enactment of the ACA
d. More people eligible for Medicare means fewer opportunities for health plans - CORRECT
ANSWER c. Enrollment has increased since the enactment of the ACA
A large metropolitan area has strong competition among several health plans and sophisticated
employers, consumers, and providers. This describes a...
a. Consolidated market
b. Mature market
c. Immature market
d. Undeveloped market - CORRECT ANSWER b. Mature market
Select one of the options below to complete the sentence. Consolidation (mergers and
acquisitions) in health plans...
a. Has declined in recent years
b. Increases efficiency and entails few costs
c. Has been driven in part by the ACA
d. Has not been matched by consolidation among providers - CORRECT ANSWER c. Has been
driven in part by the ACA
Some health plans have modified their designs to address the desire of members and potential
members for greater choice in providers. This is an example of the power of
,a. Consumers
b. Purchasers
c. Providers
d. Payers - CORRECT ANSWER a. Consumers
To prove that employers' dollars are being well spent, health plans have devoted time and
money to outcomes research and other quality-ensuring initiatives. This is an example of the
power of
a. Consumers
b. Purchasers
c. Providers
d. Payers - CORRECT ANSWER b. Purchasers
New compensation methods, such as bundled payments and value-based payment models,
designed to enhance provider accountability, are an example of the power of
a. Consumers
b. Purchasers
c. Providers
d. Payers - CORRECT ANSWER d. Payers
Taking an active role in the community is
a. Common only for not-for-profit health plans
b. The right thing to do but brings a health plan no real benefits
c. Advisable for health plans, regional and national as well as locally focused
d. Legally required for all health plans - CORRECT ANSWER c. Advisable for health plans,
regional and national as well as locally focused
, ®Those with limited access to healthcare services are most commonly
a. The elderly
b. Rural people and low-income urban people
c. Residents of large cities of all income levels
d. Residents of suburban areas of all income levels - CORRECT ANSWER b. Rural people and low-
income urban people
Which statement is true about stakeholders in the health plan environment
a. Health plans may not act as vendors to self-insured employers
b. Academic medical centers have been largely insulated from changes in the environment
c. Health plans often collaborate with patient advocacy groups
d. State and federal governments are purchasers and payers as well as regulators. - CORRECT
ANSWER c. Health plans often collaborate with patient advocacy groups
The owner or owners have full responsibility for the debts of the business. This is true for...
a. Neither a sole proprietor, general partners, nor limited partners
b. A sole proprietor but not a general or limited partners
c. A sole proprietor and general partners, but not limited partners
d. A sole proprietor, general partners, and limited partners - CORRECT ANSWER c. A sole
proprietor and general partners, but not limited partners
Who can be involved in managing the day-to-day operations of a business?
a. Neither a sole proprietor, general partners, nor limited partners
b. A sole proprietor but not a general or limited partners
c. A sole proprietor and general partners, but not limited partners
d. A sole proprietor, general partners, and limited partners - CORRECT ANSWER c. A sole
proprietor and general partners, but not limited partners
