HOM 5307 ttu test 1 from practice-test
Managed Care with verified answers
passed
PPOs 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. - correct answer ✔✔True
Blue Cross began how - correct answer ✔✔1929, Baylor for teachers in Houston, TX
Blue Shield started how - correct answer ✔✔as a physician service bureau in the 1930s
BBA - correct answer ✔✔Balanced Budget Act, 1997; Reduces payment level to Medicare and
Choice plans in most of the country, below the rate of increase of medical costs & imposes
additional administrative burdens.
T/F: BBA of 1997 resulted in a major increase in HMO enrollment. - correct answer ✔✔False
chargemaster - correct answer ✔✔a list detailing the official rate charged by a hospital for
individual procedures, services, and goods
T/F: Health care cost inflation has remained consistent since 1995. - correct answer ✔✔False:
increase MCO for all types of plans, making it harder to know one plan from another; return of
rapidly rising health care cost, though the issue is far more complex than simply reducing HMO
enrollment. -return of increasing cost sharing
Prior to the 1970s, HMOs were known as: - correct answer ✔✔Prepaid Group Practices (PGP),
creation of western clinic in Tacoma, WA. the first HMO.
Managed Care with verified answers
passed
PPOs 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. - correct answer ✔✔True
Blue Cross began how - correct answer ✔✔1929, Baylor for teachers in Houston, TX
Blue Shield started how - correct answer ✔✔as a physician service bureau in the 1930s
BBA - correct answer ✔✔Balanced Budget Act, 1997; Reduces payment level to Medicare and
Choice plans in most of the country, below the rate of increase of medical costs & imposes
additional administrative burdens.
T/F: BBA of 1997 resulted in a major increase in HMO enrollment. - correct answer ✔✔False
chargemaster - correct answer ✔✔a list detailing the official rate charged by a hospital for
individual procedures, services, and goods
T/F: Health care cost inflation has remained consistent since 1995. - correct answer ✔✔False:
increase MCO for all types of plans, making it harder to know one plan from another; return of
rapidly rising health care cost, though the issue is far more complex than simply reducing HMO
enrollment. -return of increasing cost sharing
Prior to the 1970s, HMOs were known as: - correct answer ✔✔Prepaid Group Practices (PGP),
creation of western clinic in Tacoma, WA. the first HMO.
