AHM 250 PART 1 QUESTIONS WITH VERIFIED
ACCURATE ANSWERS
A health plan can best be described as an organization that - Answers - Integrates the
delivery and financing of health care and seeks to manage health care costs, access,
and quality
The earliest versions of health plans appeared - Answers - In the early 1900s
Which is a very early type of health plan? - Answers - Prepaid group practice
Which was a provision of the hmo act of 1973? - Answers - Federally qualified HMOs
had access to federal funding
In the 1990s, HMOs were - Answers - Popular because they held down costs, but
people objected to the lack of provider choice
To receive benefits from her plan, Janine must first go to here PCP and remain within
her plan's network for other health services. Janine is most likely covered by a -
Answers - Traditional HMO plan
Jacob must pay $5,000 in health care expenses each year before he receives benefits
from his health plan, but he can use money from a tax-advantaged savings account.
Jacob has a - Answers - Consumer Directed Health Plan
What is the involvement of the state and federal government in health plans? - Answers
- They legislate and regulate in this area and purchase health coverage
Under the fee-for-service compensation method, healthcare providers have a financial
incentive to provide - Answers - More services
Which of these do health plans generally seek to replace? - Answers - Fee for service
compensation
A consumer directed health plan seeks to lower premiums through - Answers - A high
deductible
In relation to health plans, over the years the definition of quality - Answers - Has
become broader
Which is an organization accrediting health plans? - Answers - NCQA
, Why is it useful in studying health plans to learn about indemnity insurance? - Answers -
Some features of today's health plans are inherited from indemnity insurance or
designated to address its problems
Andy and his family are cover by his employer's group health insurance policy. Who is
the (are) the policy holder(s) of this policy? - Answers - The employer
Who pays the premium of an employer sponsored group policy? - Answers - Employees
may pay part or all of the premium, but they do so through the employer.
What happens in adverse selection? - Answers - People who need health care enroll in
greater numbers than average people
Which employee group is most likely to have a higher than average loss rate? -
Answers - A group made up of mostly women
Which employee group presents a high risk of adverse selection? - Answers - In
Company A, a small percentage of employees enroll
In traditional indemnity health insurance, insureds - Answers - Can go to any provider
they choose
In traditional indemnity health insurance, how are providers compensated? - Answers -
Fee-for-service
Owen pays 20% of the cost of health care services covered by his policy. This
describes - Answers - Coinsurance
Which is not common in traditional indemnity health insurance? - Answers - Copayment
Coordination of Benefits is designed to - Answers - Prevent duplication of benefits when
a person is covered by more than one health insurance policy
Increased cost sharing - Answers - All of the above (shifts cost from insurer to insured,
can help to lower the level of premium increases, helps hold down health care
expenditures through insured incentives)
According to the text, cost containment helps hold down death insurance premiums
primarily by - Answers - Reducing unnecessary health car services
Coverage of preventative care is - Answers - Cost effective in the long run
In this course, "health plan" is defined as any entity that - Answers - Uses certain
concepts of techniques to manage the cost, access, and quality of health care
ACCURATE ANSWERS
A health plan can best be described as an organization that - Answers - Integrates the
delivery and financing of health care and seeks to manage health care costs, access,
and quality
The earliest versions of health plans appeared - Answers - In the early 1900s
Which is a very early type of health plan? - Answers - Prepaid group practice
Which was a provision of the hmo act of 1973? - Answers - Federally qualified HMOs
had access to federal funding
In the 1990s, HMOs were - Answers - Popular because they held down costs, but
people objected to the lack of provider choice
To receive benefits from her plan, Janine must first go to here PCP and remain within
her plan's network for other health services. Janine is most likely covered by a -
Answers - Traditional HMO plan
Jacob must pay $5,000 in health care expenses each year before he receives benefits
from his health plan, but he can use money from a tax-advantaged savings account.
Jacob has a - Answers - Consumer Directed Health Plan
What is the involvement of the state and federal government in health plans? - Answers
- They legislate and regulate in this area and purchase health coverage
Under the fee-for-service compensation method, healthcare providers have a financial
incentive to provide - Answers - More services
Which of these do health plans generally seek to replace? - Answers - Fee for service
compensation
A consumer directed health plan seeks to lower premiums through - Answers - A high
deductible
In relation to health plans, over the years the definition of quality - Answers - Has
become broader
Which is an organization accrediting health plans? - Answers - NCQA
, Why is it useful in studying health plans to learn about indemnity insurance? - Answers -
Some features of today's health plans are inherited from indemnity insurance or
designated to address its problems
Andy and his family are cover by his employer's group health insurance policy. Who is
the (are) the policy holder(s) of this policy? - Answers - The employer
Who pays the premium of an employer sponsored group policy? - Answers - Employees
may pay part or all of the premium, but they do so through the employer.
What happens in adverse selection? - Answers - People who need health care enroll in
greater numbers than average people
Which employee group is most likely to have a higher than average loss rate? -
Answers - A group made up of mostly women
Which employee group presents a high risk of adverse selection? - Answers - In
Company A, a small percentage of employees enroll
In traditional indemnity health insurance, insureds - Answers - Can go to any provider
they choose
In traditional indemnity health insurance, how are providers compensated? - Answers -
Fee-for-service
Owen pays 20% of the cost of health care services covered by his policy. This
describes - Answers - Coinsurance
Which is not common in traditional indemnity health insurance? - Answers - Copayment
Coordination of Benefits is designed to - Answers - Prevent duplication of benefits when
a person is covered by more than one health insurance policy
Increased cost sharing - Answers - All of the above (shifts cost from insurer to insured,
can help to lower the level of premium increases, helps hold down health care
expenditures through insured incentives)
According to the text, cost containment helps hold down death insurance premiums
primarily by - Answers - Reducing unnecessary health car services
Coverage of preventative care is - Answers - Cost effective in the long run
In this course, "health plan" is defined as any entity that - Answers - Uses certain
concepts of techniques to manage the cost, access, and quality of health care
