AHM 250 STUDY WITH COMPLETE SOLUTION RATED A+
100% VERIFIED CORRECT
In an open-access HMO, mbrs..
- - Ans receive lower benefits for non-network care
which statement best describes an open-panel HMO - Ans 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 - Ans Physicians are employees of the hMO or mbrs of
a contracted group
Which is true about closed-acess HMO - Ans 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 - Ans
discounted fee for service
In which compensa%on method do physicians assume risk?
- - Ans capita%on
An HMO pays a dr a certain amount per mbr per month to provide care needed by HMO mbrs.
This describes..
-cap%a%on
,-discounted fee for service
-fee for sercive - Ans capita%on
A mixed model HMO is one that - Ans combines feature of different HMO models
The current trend is towards
-mixed model HMOs
-staff model HMO
-group model - Ans mixed model
in which hmo model does doctor manage her own office
-group model
-IPA model
-staff model - Ans IPA model
how are IPA physicians most commonly compensated?
-capita%on 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 - Ans -capita%on 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 facili%es
-mbrs have limited control of care mngnmy - Ans 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 - Ans recieve lower benefits fro non-network care
What is true about a closed panel HMO?
-Physicians can see pa%ents 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 - Ans 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 - Ans 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
-capita%on for PCPs and discounted fee-for-service of RBRVS for specialist
-salaries for PCPs and discounted fee for service
-regular fee for service - Ans capita%on 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
100% VERIFIED CORRECT
In an open-access HMO, mbrs..
- - Ans receive lower benefits for non-network care
which statement best describes an open-panel HMO - Ans 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 - Ans Physicians are employees of the hMO or mbrs of
a contracted group
Which is true about closed-acess HMO - Ans 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 - Ans
discounted fee for service
In which compensa%on method do physicians assume risk?
- - Ans capita%on
An HMO pays a dr a certain amount per mbr per month to provide care needed by HMO mbrs.
This describes..
-cap%a%on
,-discounted fee for service
-fee for sercive - Ans capita%on
A mixed model HMO is one that - Ans combines feature of different HMO models
The current trend is towards
-mixed model HMOs
-staff model HMO
-group model - Ans mixed model
in which hmo model does doctor manage her own office
-group model
-IPA model
-staff model - Ans IPA model
how are IPA physicians most commonly compensated?
-capita%on 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 - Ans -capita%on 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 facili%es
-mbrs have limited control of care mngnmy - Ans 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 - Ans recieve lower benefits fro non-network care
What is true about a closed panel HMO?
-Physicians can see pa%ents 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 - Ans 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 - Ans 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
-capita%on for PCPs and discounted fee-for-service of RBRVS for specialist
-salaries for PCPs and discounted fee for service
-regular fee for service - Ans capita%on 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
