HOM 5307 EXAM 2 ACTUAL QUESTIONS AND ANSWERS
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 - CORRECT ANSWER✅✅D- all of the above
T/F
Recent legislation encourages separate lifetime limits for behavioral care. - CORRECT ANSWER✅✅false
T/F
The majority of prescriptions for behavioral health medications are written by non-psychiatrists. -
CORRECT ANSWER✅✅true
T/F
Physicians treating gynecological patients diagnose substance abuse approximately 30% of the time. -
CORRECT ANSWER✅✅false
Approximately 50% of behavioral care spending is associated with what percentage of patients?
A- 5%
B- 10%
C- 15%
D- 20% - CORRECT ANSWER✅✅A- 5%
, Which organization does NOT accredit managed behavioral health care companies? - CORRECT
ANSWER✅✅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 - CORRECT ANSWER✅✅E- all of the above
T/F
Behavioral health care providers are paid under methodologies similar to those applied to
medical/surgical care providers. - CORRECT ANSWER✅✅true
T/F
Pay for performance (P4P) cannot be applied to behavioral health care providers. - CORRECT
ANSWER✅✅false
T/F
HEDIS is the most widely used set of measures for reporting on managed behavioral health care. -
CORRECT ANSWER✅✅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
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 - CORRECT ANSWER✅✅D- all of the above
T/F
Recent legislation encourages separate lifetime limits for behavioral care. - CORRECT ANSWER✅✅false
T/F
The majority of prescriptions for behavioral health medications are written by non-psychiatrists. -
CORRECT ANSWER✅✅true
T/F
Physicians treating gynecological patients diagnose substance abuse approximately 30% of the time. -
CORRECT ANSWER✅✅false
Approximately 50% of behavioral care spending is associated with what percentage of patients?
A- 5%
B- 10%
C- 15%
D- 20% - CORRECT ANSWER✅✅A- 5%
, Which organization does NOT accredit managed behavioral health care companies? - CORRECT
ANSWER✅✅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 - CORRECT ANSWER✅✅E- all of the above
T/F
Behavioral health care providers are paid under methodologies similar to those applied to
medical/surgical care providers. - CORRECT ANSWER✅✅true
T/F
Pay for performance (P4P) cannot be applied to behavioral health care providers. - CORRECT
ANSWER✅✅false
T/F
HEDIS is the most widely used set of measures for reporting on managed behavioral health care. -
CORRECT ANSWER✅✅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
