AHM 250 QUESTIONS WITH VERIFIED ACCURATE
ANSWERS
In an open-access HMO, mbrs..
- - Answers - receive lower benefits for non-network care
which statement best describes an open-panel HMO - Answers - any physician who
meets the HMO standard is eligible to join its network, but the HMO is not obligated to
contract with anyone
Which is true about closed-panel HMO - Answers - Physicians are employees of the
hMO or mbrs of a contracted group
Which is true about closed-acess HMO - Answers - in the past most HMO had closed
access, but this is no longer true
An HMO pays a doctor for his services based on a fee scedule. this is an example of -
Answers - discounted fee for service
In which compensation method do physicians assume risk?
- - Answers - capitation
An HMO pays a dr a certain amount per mbr per month to provide care needed by HMO
mbrs. This describes..
-captiation
-discounted fee for service
-fee for sercive - Answers - capitation
A mixed model HMO is one that - Answers - combines feature of different HMO models
The current trend is towards
-mixed model HMOs
-staff model HMO
-group model - Answers - mixed model
in which hmo model does doctor manage her own office
,-group model
-IPA model
-staff model - Answers - IPA model
how are IPA physicians most commonly compensated?
-capitation for PCPs and discounted fee for service of RBRVS for specialists
-salaries for PCPs and discounted fee for service for specialist
-regular fee for services for both PCPd and specialist - Answers - -capitation for PCPs
and discounted fee for service of RBRVS for specialists
Which is a disadvantage of the IPA model of HMO
-The HMO has limited control of care mngt and quality
-the cost of building and maintaining facilities
-mbrs have limited control of care mngnmy - Answers - The hmo has limited control of
care mngmt
In an open-access HMO, mbrs
-Recieve benefits only for care from network providers
-need referral from their pcps to see specialist
-receive lower benefits for non-network care - Answers - recieve lower benefits fro non-
network care
What is true about a closed panel HMO?
-Physicians can see patients who are not mbrs of the HMO
-Most HMO today have a closed panel
-physicians are employees of the HMO or mbr of contracted group - Answers -
physicians are employees of the HMO or mbr of contracted group.
Which statement best describes an open-panel HMO?
,-Any physician who meets the HMO standards has a right to join the network
-Any physican who meets the HMO standard is eligible to join its network, but the HMP
is not obligated to contract with anyone - Answers - Any physican who meets the HMO
standard is eligible to join its network, but the HMP is not obligated to contract with
anyone
How are IPA physicians most commonly compensated
-capitation for PCPs and discounted fee-for-service of RBRVS for specialist
-salaries for PCPs and discounted fee for service
-regular fee for service - Answers - capitation for PCPS and discounted fee for service
for RBRVS for specialist
An HMO pays a doctor for his services based on a fee schedule, this is a
-fee for service
-discounted fee for service
-capitation - Answers - discounted fee for service
In which compensation method do physicians assume risk
-capitation
-discounted fee for service
-fee for service - Answers - captitation
A mixed model HMO is one that
-contracts with more than one group
-combines features of different HMO models
-allows affilliated physicians to contract with other health plans - Answers - combines
features of different HMO models
In which HMO do dra normally work in a central facility owned and operated by the
HMO
-staff model
, -IPA model
-network model - Answers - staff model
In the staff model HMo, physicians are normally
-employees of a group practice contracted with the HMO
-employees of the HMO
-contracted with the HMO ` - Answers - employees of HMO
How do staff model HMOs normally compensate phyisicians
-salary
-capitation
-discounted fee for service - Answers - salary
Which is NOT an advantage of a staff model HMO
-economies of scale because of centralization
-tight control of care management
-low facility cost - Answers - low facility cost
in a group model HMO, physicians are
-employees of the HMO
-employees of the group practice
-contracted with the HMO - Answers - employees of the group practice
The HMO contracts with a single group practice. this describes
-a group model HMO
-a network model HMO
-an IPA model - Answers - a group model HMO
What is the most common compensation system in a group model HMO?
ANSWERS
In an open-access HMO, mbrs..
- - Answers - receive lower benefits for non-network care
which statement best describes an open-panel HMO - Answers - any physician who
meets the HMO standard is eligible to join its network, but the HMO is not obligated to
contract with anyone
Which is true about closed-panel HMO - Answers - Physicians are employees of the
hMO or mbrs of a contracted group
Which is true about closed-acess HMO - Answers - in the past most HMO had closed
access, but this is no longer true
An HMO pays a doctor for his services based on a fee scedule. this is an example of -
Answers - discounted fee for service
In which compensation method do physicians assume risk?
- - Answers - capitation
An HMO pays a dr a certain amount per mbr per month to provide care needed by HMO
mbrs. This describes..
-captiation
-discounted fee for service
-fee for sercive - Answers - capitation
A mixed model HMO is one that - Answers - combines feature of different HMO models
The current trend is towards
-mixed model HMOs
-staff model HMO
-group model - Answers - mixed model
in which hmo model does doctor manage her own office
,-group model
-IPA model
-staff model - Answers - IPA model
how are IPA physicians most commonly compensated?
-capitation for PCPs and discounted fee for service of RBRVS for specialists
-salaries for PCPs and discounted fee for service for specialist
-regular fee for services for both PCPd and specialist - Answers - -capitation for PCPs
and discounted fee for service of RBRVS for specialists
Which is a disadvantage of the IPA model of HMO
-The HMO has limited control of care mngt and quality
-the cost of building and maintaining facilities
-mbrs have limited control of care mngnmy - Answers - The hmo has limited control of
care mngmt
In an open-access HMO, mbrs
-Recieve benefits only for care from network providers
-need referral from their pcps to see specialist
-receive lower benefits for non-network care - Answers - recieve lower benefits fro non-
network care
What is true about a closed panel HMO?
-Physicians can see patients who are not mbrs of the HMO
-Most HMO today have a closed panel
-physicians are employees of the HMO or mbr of contracted group - Answers -
physicians are employees of the HMO or mbr of contracted group.
Which statement best describes an open-panel HMO?
,-Any physician who meets the HMO standards has a right to join the network
-Any physican who meets the HMO standard is eligible to join its network, but the HMP
is not obligated to contract with anyone - Answers - Any physican who meets the HMO
standard is eligible to join its network, but the HMP is not obligated to contract with
anyone
How are IPA physicians most commonly compensated
-capitation for PCPs and discounted fee-for-service of RBRVS for specialist
-salaries for PCPs and discounted fee for service
-regular fee for service - Answers - capitation for PCPS and discounted fee for service
for RBRVS for specialist
An HMO pays a doctor for his services based on a fee schedule, this is a
-fee for service
-discounted fee for service
-capitation - Answers - discounted fee for service
In which compensation method do physicians assume risk
-capitation
-discounted fee for service
-fee for service - Answers - captitation
A mixed model HMO is one that
-contracts with more than one group
-combines features of different HMO models
-allows affilliated physicians to contract with other health plans - Answers - combines
features of different HMO models
In which HMO do dra normally work in a central facility owned and operated by the
HMO
-staff model
, -IPA model
-network model - Answers - staff model
In the staff model HMo, physicians are normally
-employees of a group practice contracted with the HMO
-employees of the HMO
-contracted with the HMO ` - Answers - employees of HMO
How do staff model HMOs normally compensate phyisicians
-salary
-capitation
-discounted fee for service - Answers - salary
Which is NOT an advantage of a staff model HMO
-economies of scale because of centralization
-tight control of care management
-low facility cost - Answers - low facility cost
in a group model HMO, physicians are
-employees of the HMO
-employees of the group practice
-contracted with the HMO - Answers - employees of the group practice
The HMO contracts with a single group practice. this describes
-a group model HMO
-a network model HMO
-an IPA model - Answers - a group model HMO
What is the most common compensation system in a group model HMO?
