HOM 5307 Questions and Correct Verified Answers
Prior to the 1970s, health maintenance organizations were known as
prepaid practice groups
In what model does an HMO contract with more than one group practice provide medical
services to its members?
Network model
Advantages of an IPA include
broader physician choice for members
more convenient geographic access
requires less start-up capital
Capitation is usually defined as
Prepayment for services on a fixed, per member per month basis
CH 4: when selecting a hosptial during the network development phase, an HMO considers:
occupancy rate
cost of services
scope of services
The original impetus of HMOs development came from
Providers seeking patient revenues
Consumers seeking access to healthcare
Employers
Ancillary services are broadly divided into the following categories
diagnostic and therapeutic
The integral compound of managed care are:
, Wellness and prevention
Primary care orientation
Utilization management
Managed care is best described as:
A broad and constantly changing array of health plans employers, unions and other purchaser
of care that attempt to manage cost, quality, and access to that care
Commonly recognized HMOs include:
IPAs
Network
Staff and group
The managed care backlash resulted in which of the following?
A reduction in HMO membership
New federal and state law regulations
EPOs share similarities with:
PPOs
HMOs
state and federal regulations consistently apply network access standards to:
HMOs
POS (point of service) plan
A PHO (physician health organization) is usually a separate business entity requiring the
participation of a hospital and at least some of the hospital's admitting physicians
true
PPOs differ HMOs bc 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
Prior to the 1970s, health maintenance organizations were known as
prepaid practice groups
In what model does an HMO contract with more than one group practice provide medical
services to its members?
Network model
Advantages of an IPA include
broader physician choice for members
more convenient geographic access
requires less start-up capital
Capitation is usually defined as
Prepayment for services on a fixed, per member per month basis
CH 4: when selecting a hosptial during the network development phase, an HMO considers:
occupancy rate
cost of services
scope of services
The original impetus of HMOs development came from
Providers seeking patient revenues
Consumers seeking access to healthcare
Employers
Ancillary services are broadly divided into the following categories
diagnostic and therapeutic
The integral compound of managed care are:
, Wellness and prevention
Primary care orientation
Utilization management
Managed care is best described as:
A broad and constantly changing array of health plans employers, unions and other purchaser
of care that attempt to manage cost, quality, and access to that care
Commonly recognized HMOs include:
IPAs
Network
Staff and group
The managed care backlash resulted in which of the following?
A reduction in HMO membership
New federal and state law regulations
EPOs share similarities with:
PPOs
HMOs
state and federal regulations consistently apply network access standards to:
HMOs
POS (point of service) plan
A PHO (physician health organization) is usually a separate business entity requiring the
participation of a hospital and at least some of the hospital's admitting physicians
true
PPOs differ HMOs bc 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
