HOM 5307 Exam 1 Questions and Correct Verified
Answers
T/F
PSOs, created by the BBA of 1997, proved to be very popular and successful
false
they failed spectacularly
PSO = physician service organization
BBA = balanced budget act
key common characteristics of PPOs include:
A- Selected provider panels
B- Negotiated payment rates
C- Consumer choice & Utilization management
D- All the above
D- all of the above
advantages of an IPA include:
A- Broader physician choice for members
B- More convenient geographic access
C- Requires less start-up capital
D- All the above
,D- all of the above
(HMOs are extremely costly)
capitation is usually described as:
A- Fee-for-service including withhold provisions
B- Stop-loss reinsurance provisions
C- Prepayment for services on a fixed, per member per month basis
D- Performance based compensation system
C- prepayment for services on a fixed, per member per month basis
in what model does an HMO contract with more than one group practice to provide medical
services to its members?
A- Group model
B- Staff model
C- Independent Physician Association model
D- Network model
D- network model
the integral components of managed care are:
A- Wellness and prevention
B- Primary care orientation
C- Utilization management
D- All of the above
D- all of the above
managed care is best described as:
, A- 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
B- A broad changing array of health plans employers, unions, and other purchasers of care.
C- A constantly changing array of unions, and other purchasers of care that attempt
to manage cost, quality, and access to that care
D- A array of health plans employers, unions, and other purchasers of care that attempt
to manage cost, quality, and access to that care
A- 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 were known as:
A- Point-of-service programs
B- Referred provider organizations
C- Prepaid practices
D- Prepaid group practices
D- prepaid group practices
(creation of western clinic in Tacoma, WA. was the first HMO.)
the original impetus of HMOs development came from:
A- Providers seeking patient revenues
B- Insurance companies
C- Consumers seeking access to health care
D- employers
E- A, C and D
Answers
T/F
PSOs, created by the BBA of 1997, proved to be very popular and successful
false
they failed spectacularly
PSO = physician service organization
BBA = balanced budget act
key common characteristics of PPOs include:
A- Selected provider panels
B- Negotiated payment rates
C- Consumer choice & Utilization management
D- All the above
D- all of the above
advantages of an IPA include:
A- Broader physician choice for members
B- More convenient geographic access
C- Requires less start-up capital
D- All the above
,D- all of the above
(HMOs are extremely costly)
capitation is usually described as:
A- Fee-for-service including withhold provisions
B- Stop-loss reinsurance provisions
C- Prepayment for services on a fixed, per member per month basis
D- Performance based compensation system
C- prepayment for services on a fixed, per member per month basis
in what model does an HMO contract with more than one group practice to provide medical
services to its members?
A- Group model
B- Staff model
C- Independent Physician Association model
D- Network model
D- network model
the integral components of managed care are:
A- Wellness and prevention
B- Primary care orientation
C- Utilization management
D- All of the above
D- all of the above
managed care is best described as:
, A- 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
B- A broad changing array of health plans employers, unions, and other purchasers of care.
C- A constantly changing array of unions, and other purchasers of care that attempt
to manage cost, quality, and access to that care
D- A array of health plans employers, unions, and other purchasers of care that attempt
to manage cost, quality, and access to that care
A- 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 were known as:
A- Point-of-service programs
B- Referred provider organizations
C- Prepaid practices
D- Prepaid group practices
D- prepaid group practices
(creation of western clinic in Tacoma, WA. was the first HMO.)
the original impetus of HMOs development came from:
A- Providers seeking patient revenues
B- Insurance companies
C- Consumers seeking access to health care
D- employers
E- A, C and D
