HOM EXAM 1
study set with 100% verified solutions-
personalized success 2025
True/false? Recent legislation encourages separate lifetime
limits for behavioral care
False
True/false? Extended inpatient treatment for substance abuse is
clearly more effective, but too costly
False
True/false? Behavioral health care providers are paid under
methodologies similar to those applied to medical/surgical care
providers
True
True/false? Pay for performance (P4P) cannot be applied to
behavioral health providers
False
Approximately 50% of behavioral care spending is associated
with what percentage of patients?
,5%
Which organization does not accredit managed behavioral
health care companies?
American College of Mental Health Administration
True/false? HEDIS is the most widely used set of measures for
reporting on managed behavioral health care
True
Prior to the 1970s, health maintenance organizations were
known as
Prepaid group practices
The original impetus of HMOs development came from
Providers seeking patient revenues
Consumers seeking access to health care
Employers
The integral components 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 purchasers of care that attempt
to manage cost, quality, and access to that care
The managed care backlash resulted in which of the following
A reduction in HMO membership
New federal and state laws and regulations
True/false? PPOs differ from HMOs because they do not accept
capitation risk and enrollees are willing to pay higher cost
sharing may access providers that are not in the contracted
network
True
True/false? Blue cross began as a physician service bureau in
the 1930s
False
study set with 100% verified solutions-
personalized success 2025
True/false? Recent legislation encourages separate lifetime
limits for behavioral care
False
True/false? Extended inpatient treatment for substance abuse is
clearly more effective, but too costly
False
True/false? Behavioral health care providers are paid under
methodologies similar to those applied to medical/surgical care
providers
True
True/false? Pay for performance (P4P) cannot be applied to
behavioral health providers
False
Approximately 50% of behavioral care spending is associated
with what percentage of patients?
,5%
Which organization does not accredit managed behavioral
health care companies?
American College of Mental Health Administration
True/false? HEDIS is the most widely used set of measures for
reporting on managed behavioral health care
True
Prior to the 1970s, health maintenance organizations were
known as
Prepaid group practices
The original impetus of HMOs development came from
Providers seeking patient revenues
Consumers seeking access to health care
Employers
The integral components 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 purchasers of care that attempt
to manage cost, quality, and access to that care
The managed care backlash resulted in which of the following
A reduction in HMO membership
New federal and state laws and regulations
True/false? PPOs differ from HMOs because they do not accept
capitation risk and enrollees are willing to pay higher cost
sharing may access providers that are not in the contracted
network
True
True/false? Blue cross began as a physician service bureau in
the 1930s
False
