HSM 543 Week 3 Quiz (Winter) 100% CORRECT questions and answers elaborations.

HSM 543 Week 3 Quiz CO C) A method of providing coverage where the employer assumes risk is managed care. point of service. closed panel HMO. direct contracting. preferred provider organization. (CO C) Which of the following describes open-panel HMOs? Member physicians are not employees of the association. Member physicians are employees of the association. They provide incentive payments to physicians. They rely on a group of primary physicians. CO C) The methods of payment used by third-party payers include all except cost. charges. discount from charges. capitation. All of the above (CO C) The goal of SCHIP is to expand Medicaid eligibility to pregnant women. to provide Medicaid beneficiaries with dental coverage. to provide Medicaid beneficiaries with outpatient coverage. to expand Medicaid coverage to children from families with incomes up to 200% of the poverty level. (CO C) A method of providing coverage where the employer assumes risk is 24199 managed care. 29143 point of service. You Answered 87360 closed panel HMO. Correct Answer 97538 direct contracting. 10545 preferred provider organization. See Nowicki, page 73. Move To... Question 2 5 / 5 pts (CO C) Which of the following describes open-panel HMOs? Correct! 25662 Member physicians are not employees of the association. 4021 Member physicians are employees of the association. They provide incentive payments to physicians. 13046 They rely on a group of primary physicians. See Nowicki, page 82. Move To... Question 3 5 / 5 pts (CO C) The methods of payment used by third-party payers include all except 15721 cost. 83743 charges. 27885 discount from charges. 21225 capitation. Correct! 11652 All of the above See Nowicki, pages 86–87. Move To... Question 4 5 / 5 pts (CO C) The goal of SCHIP is 90269 to expand Medicaid eligibility to pregnant women. 46937 to provide Medicaid beneficiaries with dental coverage. 7481 to provide Medicaid beneficiaries with outpatient coverage. Correct! 74352 to expand Medicaid coverage to children from families with incomes up to 200% of the poverty level. See Nowicki, page 111. To manage increased risk, HMOs contain costs with aggressive methods of controlling use that do not include (CO C) Managed care organizations (MCOs) do all the following except be called commercial indemnity plans. Show Less