NR-511 Week 1 Quiz (Jan 2021) Question: Most health maintenance organizations (HMOs) use a reimbursement mechanism called capitation. What does this mean? Question: The Affordable Care Act (ACA) whi ch passed in 2010 has a number of provisions, including the establishment of health exchanges. The p...
Question 1
pts
Most health maintenance organizations (HMOs) use a reimbursement mechanism
called capitation. What does this mean?
The HMO is not responsible for provider reimbursement.
The HMO reimburses the provider only if the patient has paid their deductible.
The HMO reimburses the provider on a fee-for-service basis.
The HMO reimburses the provider a predetermined fee per client per month based on
the client’s age and sex.
The reimbursement mechanism called capitation that some HMOs use is one in which
the HMO reimburses the provider a set fee per client per month based on the client's
age and sex. HMOs are prepaid, comprehensive systems of health benefits that
combine both financing and delivery of services to subscribers. They may pay providers
on a capitated or fee-for-service basis.
Question 2
pts
The Affordable Care Act (ACA) which passed in 2010 has a number of provisions,
including the establishment of health exchanges. The purpose of a health insurance
exchange is to:
Require each state to sell health insurance policies to consumers.
Reduce the overall out-of-pocket cost of health insurance to the consumer.
Reduce the number of consumer health claims to the insurer.
Create an online marketplace for the sale and purchase of health insurance for
consumers.
The health insurance exchange was created to provide a website for consumers to
compare health insurance policies. Therefore, it is a marketplace for the sale and
This study source was downloaded by 100000829957125 from CourseHero.com on 11 -09-2021 00:46:52 GMT -06:00
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller ProfGoodlucK. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.99. You're not tied to anything after your purchase.
