QUESTION: 133

One ethical principle in managed care is the principle of justice/equity, which specifically holds that MCOs and their providers have a duty to

treat each member in a manner that respects his or her own goals and values
allocate resources in a way that fairly distributes benefits and burdens among the members
present information honestly to their members and to honor commitments to their members
make sure they do not harm their members

Answer(s): B

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One factor the Sandpiper Health Plan uses to assess its quality is a clinician's bedside manner, i.e., how friendly and understanding the clinician is, whether the patient feels that the clinician listens to the patient's concerns, how well the clinical

a provider service quality issue
an administrative service quality issue a healthcare process quality issue
a healthcare outcomes quality issue
a healthcare process quality issue

Answer(s): A

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QUESTION: 135

One feature of the Employee Retirement Income Security Act (ERISA) is that it:

Requires self-funded employee benefit plans to pay premium taxes at the state level.
Contains a pre-emption provision, which typically makes the terms of ERISA take precedence over any state laws that regulate employee welfare benefit plans.
Contains strict reporting and disclosure requirements for all employee benefit plans except health plans.
Requires that state insurance laws apply to all employee benefit plans except insured plans.

Answer(s): B

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QUESTION: 136

One HMO model can be described as an extension of a group model HMO because it contracts with multiple group practices, rather than with a single group practice. This HMO model is known as the

staff model HMO
IPA model HMO
direct contract model HMO
network model HMO

Answer(s): D

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Free AHM-250 Exam Braindumps (page: 34)

QUESTION: 133

QUESTION: 134

QUESTION: 135

QUESTION: 136