HOM 5307 Exam 2

HOM 5307 Exam 2 What technique is used by many pharmaceutical companies with health plans and PBMs to increase formulary access and utilization of specific products? A- Rebates for preferred formulary position B- Health economic data, including a growing number of head-to-head clinical trials C- Member copayment coupons to offset copayment D- All the above - D- all of the above T/F Recent legislation encourages separate lifetime limits for behavioral care. - false T/F The majority of prescriptions for behavioral health medications are written by non-psychiatrists. - true T/F Physicians treating gynecological patients diagnose substance abuse approximately 30% of the time. - false Approximately 50% of behavioral care spending is associated with what percentage of patients? A- 5% B- 10% C- 15% D- 20% - A- 5% Which organization does NOT accredit managed behavioral health care companies? - American College of Mental Health Administration Which organization(s) accredit managed behavioral health care companies? A- National Committee for Quality Assurance B- The Joint Commission C- Utilization Review Accreditation Commission D- Councile of Accreditation E- All the above - E- all of the above T/F Behavioral health care providers are paid under methodologies similar to those applied to medical/surgical care providers. - true T/F Pay for performance (P4P) cannot be applied to behavioral health care providers. - false T/F HEDIS is the most widely used set of measures for reporting on managed behavioral health care. - true (HEDIS = Healthcare Effectiveness Data and Information Set) which of the following entities must document quality improvement processes in order to gain URAC accreditation? A. Credentials verification organizations