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AHM-250 Exam Dumps : Healthcare Management: An Introduction

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Healthcare Management: An Introduction Questions and Answers

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Question 1

The following statements describe violations of antitrust legislation:

Situation A - Two health plans in a single service area divided purchasers into two groups and agreed to each market their products to only one purchaser group.

Situation B - A spec

Options:

A.

Situation A - horizontal division of markets Situation B - tying arrangement.

B.

Situation A - horizontal division of markets Situation B - price fixing.

C.

Situation A - horizontal group boycott Situation B - tying arrangement.

D.

Situation A - horizontal group boycott Situation B - price fixing.

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Question 2

One typical characteristic of preferred provider organization (PPO) benefit plans is that PPOs:

Options:

A.

Assume full financial risk for arranging medical services for their members.

B.

Require plan members to obtain a referral before getting medical services from specialists.

C.

Use a capitation arrangement, instead of a fee schedule, to reimburse physicians.

D.

Offer some coverage, although at a higher cost, for plan members who choose to use the services of non-network providers.

Question 3

PBM plans operate under several types of contractual arrangements. Under one contractual arrangement, the PBM plan and the employer agree on a target cost per employee per month. If the actual cost per employee per month is greater than the target cost, t

Options:

A.

fee-for-service arrangement

B.

risk sharing contract

C.

capitation contract

D.

rebate contract

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