Ahm 250 Study Updated Questions And Correct Answers

AHM 250 STUDY UPDATED 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 eligi-ble 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.. -captiation -discounted fee for service -fee for sercive
Answer:
capitation

Question:
8. A mixed model HMO is one that
Answer:
combines feature of dif-ferent HMO models

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

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

Question:
11. how are IPA physicians most commonly compensat-ed?
-capitation for PCPs and discounted fee for service of RBRVS for specialists -salaries for PCPs and
discounted fee for service for specialist -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 -The HMO has limited control of care mngt
and quality -the cost of building and maintaining facilities -mbrs have limited control of care
mngnmy
Answer:
The hmo has limited con-trol of care mngmt

Question:
13. In an open-access HMO, mbrs -Recieve benefits only for care from network providers -need
referral from their pcps to see specialist -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?
-Physicians can see patients who are not mbrs of the HMO -Most HMO today have a closed panel
-physicians are employees of the HMO or mbr of con-tracted group
Answer:
physicians are employees of the HMO or mbr of con-tracted group.

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

,Question:
16. How are IPA physicians most commonly compensat-ed -capitation for PCPs and discounted
fee-for-service of RBRVS for specialist -salaries for PCPs and discounted fee for service -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 -fee for service
-discounted fee for service -capitation
Answer:
discounted fee for service

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

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

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

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

Question:
22. How do staff model HMOs normally compensate phy-isicians -salary -capitation -discounted fee
for service
Answer:
salary

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

, Answer:
low facility cost

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

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

Question:
26. What is the most common compensation system in a group model HMO?
- The HMO compensates the group practice by capita-
tion, and the group practice compensates physicians by discounted Fee for service -The HMO
compensates the group practice by capita-tion, and the group practice pays physicians salaries and
incentive payments -The HMO compensates the group practice by dis-counted fee-for-service, and
the group practice pays physicians salaries
Answer:
-The HMO compensates the group practice by cap-itation, and the group practice pays physicians
salaries and incentive pay-ments

Question:
27. An HMO contracts with six group practices, this is an example of a -network model -group model
-mixed model HMO
Answer:
network model

Question:
28. the most common HMO model today is the -group model 0staff model -IPA model
Answer:
IPA model

Question:
29. the trend in network model HMOs is toward -capitation only -a mix of capitation and discounted
fee for service -discounted fee for service
Answer:
mix of capitation and dis-counted fee for service

Question:
30. Which HMO model normally has a closed panel -group model -IPA model -staff model
Answer:
staff model