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NR-511 Week 1 Quiz (Latest Update) / (HMO) Questions and Answer solutions | 100% Guarateed.
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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...

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  • November 9, 2021
  • 9
  • 2021/2022
  • Exam (elaborations)
  • Questions & answers

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  • most health maintenance organizations hmos use a reimbursement mechanism called capitation what does this mea

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NR-511 Week 1 Quiz


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


https://www.coursehero.com/file/78094052/NR511-QUIZ-1docx/

, purchase of health insurance for consumers.




This study source was downloaded by 100000829957125 from CourseHero.com on 11 -09-2021 00:46:52 GMT -06:00


https://www.coursehero.com/file/78094052/NR511-QUIZ-1docx/

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