AHM-250 Random Questions And
Answers Latest Update
What describes an open panel HMO? - Answers Any physician that
meets the HMO's standards is eligible to join its network but the HMO is no
obligated to contract with anyone
What is this: physicians are employees of the HMO or members of a
contracted group? - Answers Closed Panel HMO
Open access HMO- members get what kind of benefits for OON care? -
Answers Lower benefits
What is true about to access of HMO's in regards to panes - Answers
in the past most HMO's had closed access, but now this is no longer true.
What is a mixed model HMO? - Answers Combines features of
different HMO models
What kind of HMO's are becoming more and more familiar? - Answers
Mixed Model HMO's
Which HMO model does each doctor manager her own office? -
Answers IPA Model
, Q&A
How are IPA physicians most commonly compensated? - Answers
Capitattion for PCP's and discounted FFS or RBRVS for specialists
The disadvantage of the IPA model HMO? - Answers The HMO has
limited control of care management and quality
Staff Model? - Answers HMO Model where doctors normally work in
a central facility owned and operated by the HMO
Staff model physicians are normally compensated by what??? - Answers
salary
Maid disadvantage of a staff model HMO? - Answers High Facility
Costs
The HMO contracts with a Single group practice..... this describes a? -
Answers Group Model HMO
In a group model HMO, physicians are employees of the..... - Answers
group practice contracted w/ the HMO
What is the most common compensation in a group model HMO for
physicians? - Answers THe HMO compensates with the group
practice by capitation, and the group practice pays physicians salaries and
incentive payments
, Q&A
The trend in network model HMO's is toward (payment wise..) - Answers
A mix of capitation and discounted FFS
THe most common HMO model today is.... - Answers the IPA model
Which HMO model normally has a closed panel? - Answers Staff
Model
PPOs, EPOs, and POS products are... (regarding to the managed care
continuum...) - Answers In the middle of the managed care
continuum, between tightly managed and unmanaged
PPO members receive what kind of benefits regarding OON care? -
Answers Lower Benefits
Portion of US employees (FEHB) are covered by PPOs: - Answers
A large majority
PPOs usually compensate physicians by - Answers discounted fees
Providers contracting with PPO's: (risk) - Answers may or may not
assume risk
An EPO? - Answers Exclusive Provider Organization: Operates like
a PPO but OON is generally not covered.
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