HOM exam 1 Exam Questions and
Answers (Solved Papers)
Prior to the 1970s, health maintenance organizations were
known as - Correct Answers ✅Prepaid group practices
The original impetus of HMOs development came from -
Correct Answers ✅Providers seeking patient revenues
Consumers seeking access to health care
Employers
The integral components of managed care are - Correct
Answers ✅Wellness and prevention
Primary care orientation
Utilization management
Managed care is best described as - Correct Answers ✅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
- Correct Answers ✅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
,HOM exam 1 Exam Questions and
Answers (Solved Papers)
cost sharing may access providers that are not in the
contracted network - Correct Answers ✅True
True/false? Blue cross began as a physician service bureau in
the 1930s - Correct Answers ✅False
True/false? The balance budget act (BBA) of 1997 resulted in
a major increase in HMO enrollment - Correct Answers
✅False
True/false? Health care cost inflation has remained consistent
since 1995 - Correct Answers ✅False
Briefly explain how the HMO act of 1973 may have retarded
HMO development in the few years after its enactment -
Correct Answers ✅The act imposed requirements on HMOs
but not on indemnity carriers or self insured groups, thereby
reducing the ability of HMOs to compete. In addition because
the government was slow to issue the act's regulations,
employers were reluctant to contract with HMOs until they
knew the rules under which they would be operating
Briefly explain how the HMO Act of 1973 contributed to the
growth of managed care - Correct Answers ✅The HMO Act
of 1973 authorized start up funding and ensured access to
employer based insurance. The dual choice provision required
any employer with more than 25 employees to offer at least
, HOM exam 1 Exam Questions and
Answers (Solved Papers)
one closed panel and one open panel HMO. In addition,
federal qualification was perceived as an endorsement (a seal
of good housekeeping) by the government in that the HMO
met certain standards
True/false? HMOs are licensed as health insurance companies
- Correct Answers ✅False
True/false? An IPA is an HMO that contracts directly with
physicians and hospitals - Correct Answers ✅False
True/false? The defining feature of a direct contract model is
the HMO contracting directly with a hospital to provide acute
services to its members. - Correct Answers ✅False. Direct
contracting refers to direct contracts between the HMO and
the physicians. Almost all models of HMOs contract directly
with hospitals
True/false? An IDS can be described as a legal entity
consisting of more than one type of provider to manage a
population's health care and/or contract with a payer
organization - Correct Answers ✅True
True/false? The GPWW requires the participation of a hospital
and the formation of a group practice - Correct Answers
✅False
Answers (Solved Papers)
Prior to the 1970s, health maintenance organizations were
known as - Correct Answers ✅Prepaid group practices
The original impetus of HMOs development came from -
Correct Answers ✅Providers seeking patient revenues
Consumers seeking access to health care
Employers
The integral components of managed care are - Correct
Answers ✅Wellness and prevention
Primary care orientation
Utilization management
Managed care is best described as - Correct Answers ✅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
- Correct Answers ✅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
,HOM exam 1 Exam Questions and
Answers (Solved Papers)
cost sharing may access providers that are not in the
contracted network - Correct Answers ✅True
True/false? Blue cross began as a physician service bureau in
the 1930s - Correct Answers ✅False
True/false? The balance budget act (BBA) of 1997 resulted in
a major increase in HMO enrollment - Correct Answers
✅False
True/false? Health care cost inflation has remained consistent
since 1995 - Correct Answers ✅False
Briefly explain how the HMO act of 1973 may have retarded
HMO development in the few years after its enactment -
Correct Answers ✅The act imposed requirements on HMOs
but not on indemnity carriers or self insured groups, thereby
reducing the ability of HMOs to compete. In addition because
the government was slow to issue the act's regulations,
employers were reluctant to contract with HMOs until they
knew the rules under which they would be operating
Briefly explain how the HMO Act of 1973 contributed to the
growth of managed care - Correct Answers ✅The HMO Act
of 1973 authorized start up funding and ensured access to
employer based insurance. The dual choice provision required
any employer with more than 25 employees to offer at least
, HOM exam 1 Exam Questions and
Answers (Solved Papers)
one closed panel and one open panel HMO. In addition,
federal qualification was perceived as an endorsement (a seal
of good housekeeping) by the government in that the HMO
met certain standards
True/false? HMOs are licensed as health insurance companies
- Correct Answers ✅False
True/false? An IPA is an HMO that contracts directly with
physicians and hospitals - Correct Answers ✅False
True/false? The defining feature of a direct contract model is
the HMO contracting directly with a hospital to provide acute
services to its members. - Correct Answers ✅False. Direct
contracting refers to direct contracts between the HMO and
the physicians. Almost all models of HMOs contract directly
with hospitals
True/false? An IDS can be described as a legal entity
consisting of more than one type of provider to manage a
population's health care and/or contract with a payer
organization - Correct Answers ✅True
True/false? The GPWW requires the participation of a hospital
and the formation of a group practice - Correct Answers
✅False
