Helping Hand Questions for AHM-250

Healthcare Management: An Introduction Questions and Answers

Question 33

Janet Riva is covered by a indemnity health insurance plan that specifies a $250 deductible and includes a 20% coinsurance provision. When Ms. Riva was hospitalized, she incurred $2,500 in medical expenses that were covered by her health plan. She incurred

Options:

$1,750

$1,800

$2,000

$2,250

Question 34

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

Options:

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

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

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

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

Question 35

One of the distinguishing characteristics of healthcare marketing is that many of the markets for health plans are national, not local markets.

Options:

True

False

Question 36

Several marketplace factors helped fuel the movement toward consumer choice. Which one of the following statements is NOT accurate with regard to these factors?

Options:

After a period of relative stability, annual growth in private health spending per capita began to increase rapidly in 2002.

During the height of the recent cost upswing, insurance premiums were increasing by more than 13% annually.

Increased utilization was the largest factor contributing to the rise in premiums, accounting for 43% of the increase.

Employer payers began seeking ways to control spiraling utilization rates and provide lower cost health coverage options.

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Healthcare Management: An Introduction Questions and Answers

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