AHM 250 STUDY UPDATED ACTUAL QUESTIONS AND CORRECT ANSWERS

AHM 250 STUDY UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS

Question:
1. In an open-access HMO, mbrs..
-
Answer:
receive lower benefits for non-network care

Question:
2. which statement best describes an open-panel HMO
Answer:
any physician who meets the HMO standard is eligible to join its network, but the HMO is not obligated to
contract with anyone

Question:
3. Which is true about closed-panel HMO
Answer:
Physicians are employees of the hMO or mbrs of a contracted group

Question:
4. Which is true about closed-acess HMO
Answer:
in the past most HMO had closed access, but this is no longer true

Question:
5. An HMO pays a doctor for his services based on a fee scedule. this is an example of
Answer:
discounted fee for service

Question:
6. In which compensation method do physicians assume risk?
-
Answer:
capitation

Question:
7. An HMO pays a dr a certain amount per mbr per month to provide care needed by HMO mbrs. This
describes..
A. -captiation
B. -discounted fee for service
C. -fee for sercive
Answer:
capitation

, Question:
8. A mixed model HMO is one that
Answer:
combines feature of different HMO models

Question:
9. The current trend is towards
A. -mixed model HMOs
B. -staff model HMO
C. -group model
Answer:
mixed model

Question:
10. in which hmo model does doctor manage her own office
A. -group model
B. -IPA model
C. -staff model
Answer:
IPA model

Question:
11. how are IPA physicians most commonly compensated?
A. -capitation for PCPs and discounted fee for service of RBRVS for specialists
B. -salaries for PCPs and discounted fee for service for specialist
C. -regular fee for services for both PCPd and specialist
Answer:
-capitation for PCPs and discounted fee for service of RBRVS for specialists

Question:
12. Which is a disadvantage of the IPA model of HMO
A. -The HMO has limited control of care mngt and quality
B. -the cost of building and maintaining facilities
C. -mbrs have limited control of care mngnmy
Answer:
The hmo has limited control of care mngmt

Question:
13. In an open-access HMO, mbrs
A. -Recieve benefits only for care from network providers
B. -need referral from their pcps to see specialist
C. -receive lower benefits for non-network care
Answer:
recieve lower benefits fro non-network care

, Question:
14. What is true about a closed panel HMO?
A. -Physicians can see patients who are not mbrs of the HMO
B. -Most HMO today have a closed panel
C. -physicians are employees of the HMO or mbr of contracted group
Answer:
physicians are employees of the HMO or mbr of contracted group.

Question:
15. Which statement best describes an open-panel HMO?
A. -Any physician who meets the HMO standards has a right to join the network
B. -Any physican who meets the HMO standard is eligible to join its network, but the HMP is not obligated to
contract with anyone
Answer:
Any physican who meets the HMO standard is eligible to join its network, but the HMP is not obligated to
contract with anyone

Question:
16. How are IPA physicians most commonly compensated
A. -capitation for PCPs and discounted fee-for-service of RBRVS for specialist
B. -salaries for PCPs and discounted fee for service
C. -regular fee for service
Answer:
capitation for PCPS and discounted fee for service for RBRVS for specialist

Question:
17. An HMO pays a doctor for his services based on a fee schedule, this is a
A. -fee for service
B. -discounted fee for service
C. -capitation
Answer:
discounted fee for service

Question:
18. In which compensation method do physicians assume risk
A. -capitation
B. -discounted fee for service
C. -fee for service
Answer:
captitation

Question:
19. A mixed model HMO is one that
A. -contracts with more than one group
B. -combines features of different HMO models
C. -allows affilliated physicians to contract with other health plans

, Answer:
combines features of different HMO models

Question:
20. In which HMO do dra normally work in a central facility owned and operated by the HMO
A. -staff model
B. -IPA model
C. -network model
Answer:
staff model

Question:
21. In the staff model HMo, physicians are normally
A. -employees of a group practice contracted with the HMO
B. -employees of the HMO
C. -contracted with the HMO `
Answer:
employees of HMO

Question:
22. How do staff model HMOs normally compensate phyisicians
A. -salary
B. -capitation
C. -discounted fee for service
Answer:
salary

Question:
23. Which is NOT an advantage of a staff model HMO
A. -economies of scale because of centralization
B. -tight control of care management
C. -low facility cost
Answer:
low facility cost

Question:
24. in a group model HMO, physicians are
A. -employees of the HMO
B. -employees of the group practice
C. -contracted with the HMO
Answer:
employees of the group practice

Question:
25. The HMO contracts with a single group practice. this describes
A. -a group model HMO
B. -a network model HMO
C. -an IPA model