UHI: CH 3 REVIEW QUESTIONS WITH
VERIFIED ANSWERS [ GRADED A+]
The intent of managed health care was to- ✔✔ Replace fee-for-service
plans with affordable, quality care to health care consumers
The Patient Protection and Affordable Care Act (PPACA) risk adjustment
program was- ✔✔$2,400
a 0.7 demographic risk factor and a 0.9 health status risk factor has a
risk score monetary
average of....
implemented to lessen or eliminate the influence of risk selection on
premiums charged by health plans and has a risk transfer formula,
which calculates enrollee risk scores. If an average risk score is 1.0 and
has a value of $1,500, and the formula for calculating the total
risk score is demographic risk factor + health status risk factor, a 77-
year-old patient who has
The Medical Center received a $100,000 capitation payment in January
to cover the health Care costs of 150 managed care enrollees. By the
following January, $80,000 had been expended to cover services
provided. The remaining $20,000 is.... . - ✔✔ retained by the Medical
Center as profit
©morren2024/2025.Year published 2024.
, A nonprofit organization that contracts with and acquires the clinical
and business assets of a physician practices is called a... - ✔✔ medical
foundation.
Which is responsible for supervising and coordinating health care
services for enrollees? - ✔✔ primary care provider
The term that describes requirements created by accreditation
organizations is.... - ✔✔ standards
Which administrative procedure should a medical practice follow when
it contracts with a managed care organization (MCO)?
- ✔✔ Maintain a separate bookkeeping system for each capitated plan.
Which is a voluntary process that a health care facility or organization
undergoes to demonstrate that it has met standards beyond those
required by law? - ✔✔ accreditation
Which define employer contributions and ask employees to be more
responsible for health
care decisions and cost-sharing? - ✔✔ consumer-directed health plans
©morren2024/2025.Year published 2024.
VERIFIED ANSWERS [ GRADED A+]
The intent of managed health care was to- ✔✔ Replace fee-for-service
plans with affordable, quality care to health care consumers
The Patient Protection and Affordable Care Act (PPACA) risk adjustment
program was- ✔✔$2,400
a 0.7 demographic risk factor and a 0.9 health status risk factor has a
risk score monetary
average of....
implemented to lessen or eliminate the influence of risk selection on
premiums charged by health plans and has a risk transfer formula,
which calculates enrollee risk scores. If an average risk score is 1.0 and
has a value of $1,500, and the formula for calculating the total
risk score is demographic risk factor + health status risk factor, a 77-
year-old patient who has
The Medical Center received a $100,000 capitation payment in January
to cover the health Care costs of 150 managed care enrollees. By the
following January, $80,000 had been expended to cover services
provided. The remaining $20,000 is.... . - ✔✔ retained by the Medical
Center as profit
©morren2024/2025.Year published 2024.
, A nonprofit organization that contracts with and acquires the clinical
and business assets of a physician practices is called a... - ✔✔ medical
foundation.
Which is responsible for supervising and coordinating health care
services for enrollees? - ✔✔ primary care provider
The term that describes requirements created by accreditation
organizations is.... - ✔✔ standards
Which administrative procedure should a medical practice follow when
it contracts with a managed care organization (MCO)?
- ✔✔ Maintain a separate bookkeeping system for each capitated plan.
Which is a voluntary process that a health care facility or organization
undergoes to demonstrate that it has met standards beyond those
required by law? - ✔✔ accreditation
Which define employer contributions and ask employees to be more
responsible for health
care decisions and cost-sharing? - ✔✔ consumer-directed health plans
©morren2024/2025.Year published 2024.
