IHMO TEST REVIEW CH.11 QUESTIONS AND ANSWERS
Kaiser Permanente's medical plan is a closed panel program, which means
a. only certain illnesses are covered
b. it limits the patient's choice of personal physicians
c. it limits the patient's choice of a hospital for emergency care
d. services are provided on a fee-for-service basis - CORRECT ANSWER✅✅b. it limits the patient's
choice of personal physicians.
What is the name of an organization of physicians sponsored by a state or local medical association that
is concerned with the development and delivery of medical services and the cost of health care?
a. Foundation for medical care
b. Physician provider group
c. Health care cost containment organization
d. Professional review organization - CORRECT ANSWER✅✅a. Foundation for medical care
True or False
In certain managed care plans there is an incentive for the gatekeeper to limit patient referrals to
specialists. - CORRECT ANSWER✅✅True
A significant contribution to HMO development was the
a. GIGNA plan
b. Kaiser Permanente plan
c. Health Maintenance Organization Act of 1973
d. Omnibus Budget Reconciliation Act - CORRECT ANSWER✅✅c. Health Maintenance Organization Act
of 1973.
, What plan allows members of Kaiser Permanente Medical Care Program to seek medical help from non-
Kaiser physicians?
a. Health maintenance organization (HMO)
b. Point of service (POS)
c. Independent practice association (IPA)
d. Fee for service - CORRECT ANSWER✅✅b. Point of service (POS)
An organization that gives members freedom of choice among physicians and hospitals and provides a
higher level of benefits if the providers listed on the plan are used is called a/an
a. health maintenance organization (HMO)
b. managed care organization (MCO)
c. preferred provider organization (PPO)
d. exclusive provider organization (EPO) - CORRECT ANSWER✅✅c. preferred provider organization
(PPO).
Practitioners in an HMO program may come under peer review by a professional group called a
a. peer review group
b. quality control group
c. quality improvement organization
d. utilization management corporation - CORRECT ANSWER✅✅c. quality improvement organization.
True and False
A copayment in a managed care plan is usually a fixed dollar amount (predetermined fee). - CORRECT
ANSWER✅✅True
True or False
Kaiser Permanente's medical plan is a closed panel program, which means
a. only certain illnesses are covered
b. it limits the patient's choice of personal physicians
c. it limits the patient's choice of a hospital for emergency care
d. services are provided on a fee-for-service basis - CORRECT ANSWER✅✅b. it limits the patient's
choice of personal physicians.
What is the name of an organization of physicians sponsored by a state or local medical association that
is concerned with the development and delivery of medical services and the cost of health care?
a. Foundation for medical care
b. Physician provider group
c. Health care cost containment organization
d. Professional review organization - CORRECT ANSWER✅✅a. Foundation for medical care
True or False
In certain managed care plans there is an incentive for the gatekeeper to limit patient referrals to
specialists. - CORRECT ANSWER✅✅True
A significant contribution to HMO development was the
a. GIGNA plan
b. Kaiser Permanente plan
c. Health Maintenance Organization Act of 1973
d. Omnibus Budget Reconciliation Act - CORRECT ANSWER✅✅c. Health Maintenance Organization Act
of 1973.
, What plan allows members of Kaiser Permanente Medical Care Program to seek medical help from non-
Kaiser physicians?
a. Health maintenance organization (HMO)
b. Point of service (POS)
c. Independent practice association (IPA)
d. Fee for service - CORRECT ANSWER✅✅b. Point of service (POS)
An organization that gives members freedom of choice among physicians and hospitals and provides a
higher level of benefits if the providers listed on the plan are used is called a/an
a. health maintenance organization (HMO)
b. managed care organization (MCO)
c. preferred provider organization (PPO)
d. exclusive provider organization (EPO) - CORRECT ANSWER✅✅c. preferred provider organization
(PPO).
Practitioners in an HMO program may come under peer review by a professional group called a
a. peer review group
b. quality control group
c. quality improvement organization
d. utilization management corporation - CORRECT ANSWER✅✅c. quality improvement organization.
True and False
A copayment in a managed care plan is usually a fixed dollar amount (predetermined fee). - CORRECT
ANSWER✅✅True
True or False
