HOM -5307
Key common characteristics of PPOs include - ✔️✔️A. Selected provider panels B.
Negotiated payment rates C. Consumer choice D. Utilization management
True or False? A PHO is usually a separate business entity requiring the participation of
a hospital and at least some of the hospital's admitting physicians. - ✔️✔️TRUE
True or False? An IDS can be described as a legal entity consisting of more than one
type of provider to manage a population's health care and/or contract with a payer
organization. - ✔️✔️TRUE
True or False? An IPA is an HMO that contracts directly with physicians and hospitals. -
✔️✔️FALSE
True or False? HMOs are licensed as health insurance companies. - ✔️✔️FALSE
The original impetus of HMOs development came from - ✔️✔️A. Providers seeking
patient revenues B. Consumers seeking access to health care C. Employers
True or False? Blue Cross began as a physician service bureau in the 1930s. -
✔️✔️FALSE
True or False? Health care cost inflation has remained consistent since 1995. -
✔️✔️FALSE
True or False? PPOs differ from HMOs because they do not accept capitation risk and
enrollees who are willing to pay higher cost sharing may access providers that are not in
the contracted network. - ✔️✔️TRUE
True or False? The Balance Budget Act (BBA) of 1997 resulted in a major increase in
HMO enrollment. - ✔️✔️FALSE
Advantages of an IPA include - ✔️✔️A. Broader physician choice for members B. More
convenient geographic access C. Requires less start-up capital
Managed care is best described as - ✔️✔️A broad and constantly changing array of
health plans employers, unions, and other purchasers of care that attempt to manage
cost, quality, and access to that care.
Prior to the 1970s, health maintenance organizations (HMOs) were known as -
✔️✔️Prepaid group practices
Key common characteristics of PPOs include - ✔️✔️A. Selected provider panels B.
Negotiated payment rates C. Consumer choice D. Utilization management
True or False? A PHO is usually a separate business entity requiring the participation of
a hospital and at least some of the hospital's admitting physicians. - ✔️✔️TRUE
True or False? An IDS can be described as a legal entity consisting of more than one
type of provider to manage a population's health care and/or contract with a payer
organization. - ✔️✔️TRUE
True or False? An IPA is an HMO that contracts directly with physicians and hospitals. -
✔️✔️FALSE
True or False? HMOs are licensed as health insurance companies. - ✔️✔️FALSE
The original impetus of HMOs development came from - ✔️✔️A. Providers seeking
patient revenues B. Consumers seeking access to health care C. Employers
True or False? Blue Cross began as a physician service bureau in the 1930s. -
✔️✔️FALSE
True or False? Health care cost inflation has remained consistent since 1995. -
✔️✔️FALSE
True or False? PPOs differ from HMOs because they do not accept capitation risk and
enrollees who are willing to pay higher cost sharing may access providers that are not in
the contracted network. - ✔️✔️TRUE
True or False? The Balance Budget Act (BBA) of 1997 resulted in a major increase in
HMO enrollment. - ✔️✔️FALSE
Advantages of an IPA include - ✔️✔️A. Broader physician choice for members B. More
convenient geographic access C. Requires less start-up capital
Managed care is best described as - ✔️✔️A broad and constantly changing array of
health plans employers, unions, and other purchasers of care that attempt to manage
cost, quality, and access to that care.
Prior to the 1970s, health maintenance organizations (HMOs) were known as -
✔️✔️Prepaid group practices
