HOM 5307 Test 1 Questions and Correct
Verified Answers
In the medical management area, committees serve to diffuse some elements of
responsibility and allow important input from the field into procedure and policy or even into
case-specific interpretation of existing policy (T, F)
True
.The Manged Care backlash resulted in which of the following? A.
A reduction in HMO membership
B. New federal and state laws and regulations
C. Reduced administrative costs
D. A & B Only
D. A & B Only
.Fee-for-service payment is the most common method used by HMOs to pay specialists (T,
F)
True
.Basic elements of credentialing include: A.
Hospital privileges
B. Malpractice history
C. Medical license D.
Board Exams
E. All of the above
E. All of the above
.What specific factors other than diseases commonly affect severity of illness? A.
Culture
, B. Geographic location
C. Sex
D. Age
E. All of the above
E. All of the above
.Behavioral change tools include all but which of the following? A.
Analytics
B. Termination from the
network C. Mission clarity
D. Communications
B. Termination from the network
.Most of the care in disease management systems is delivered in the inpatient setting
since the acuity is much greater (T, F)
False
.In January 2006, what large federal prescription drug program was implemented that
offered pharmacy benefits to more than 40 million people at that time and is expected
to increase by 30% throughout the next decade?
A. The Department of Defense TRICOR program
B. Public Health Service and Indian Health Service
C. State Medicaid programs
D. Medicare Part D
D. Medicare Part D
.Direct contracting refers to direct contracts between the HMO and the physicians. Almost
all models of HMOs contract directly with physicians (T, F)
False
Verified Answers
In the medical management area, committees serve to diffuse some elements of
responsibility and allow important input from the field into procedure and policy or even into
case-specific interpretation of existing policy (T, F)
True
.The Manged Care backlash resulted in which of the following? A.
A reduction in HMO membership
B. New federal and state laws and regulations
C. Reduced administrative costs
D. A & B Only
D. A & B Only
.Fee-for-service payment is the most common method used by HMOs to pay specialists (T,
F)
True
.Basic elements of credentialing include: A.
Hospital privileges
B. Malpractice history
C. Medical license D.
Board Exams
E. All of the above
E. All of the above
.What specific factors other than diseases commonly affect severity of illness? A.
Culture
, B. Geographic location
C. Sex
D. Age
E. All of the above
E. All of the above
.Behavioral change tools include all but which of the following? A.
Analytics
B. Termination from the
network C. Mission clarity
D. Communications
B. Termination from the network
.Most of the care in disease management systems is delivered in the inpatient setting
since the acuity is much greater (T, F)
False
.In January 2006, what large federal prescription drug program was implemented that
offered pharmacy benefits to more than 40 million people at that time and is expected
to increase by 30% throughout the next decade?
A. The Department of Defense TRICOR program
B. Public Health Service and Indian Health Service
C. State Medicaid programs
D. Medicare Part D
D. Medicare Part D
.Direct contracting refers to direct contracts between the HMO and the physicians. Almost
all models of HMOs contract directly with physicians (T, F)
False
