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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

In health plan terminology, demand management, as used by health plans, can best be described as

Options:

A.

an evaluation of the medical necessity, efficiency, and/or appropriateness of healthcare services and treatment plans for a given patient

B.

a series of strategies designed to reduce plan members' needs to utilize healthcare services by encouraging preventive care, wellness, member self-care, and appropriate use of healthcare services

C.

a technique that prevents a provider who is being reimbursed under a fee schedule arrangement from billing a plan member for any fees that exceed the maximum fee reimbursed by the plan

D.

a system of identifying plan members with special healthcare needs, developing a healthcare strategy to meet those needs, and coordinating and monitoring the care

Question 3

Historically most HMOs have been

Options:

A.

Closed-access HMO

B.

Closed-panel HMO

C.

Open-access HMO

D.

Open-panel HMO

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