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Free AHM-250 Exam Braindumps (page: 34)

Page 33 of 92
PDF with 367 Questions

One device that PBM plans use to manage both the cost and use of pharmaceuticals is a formulary. A formulary is defined as

  1. a listing of drugs classified by therapeutic category or disease class that are considered preferred therapy for a given managed population and that are to be used by a health plan's providers in prescribing medications
  2. a reduction in the price of a particular pharmaceutical obtained by the PBM from the pharmaceutical manufacturer
  3. drugs ordered and delivered through the mail to the PBM's plan members at a reduced cost
  4. an identification card issued by the PBM to its plan members

Answer(s): A



One distinction that can be made between a staff model HMO and a group model HMO is that, in a staff model HMO, participating physicians are Back to Top

  1. Employees of the HMO
  2. Employees of a group practice that has contracted with the HMO
  3. Compensated primarily through capitation
  4. Limited to primary care physicians (PCPs)

Answer(s): A



One distinguishing characteristic of a health maintenance organization (HMO) is that, typically, an HMO

  1. arranges for the delivery of medical care and provides, or shares in providing, the financing of that care
  2. must be organized on a not-for-profit basis
  3. may be organized as a corporation, a partnership, or any other legal entity
  4. must be federally qualified in order to conduct business in any state

Answer(s): A



One ethical principle in health plans is the principle of non-malfeasance, which holds that health plans and their providers:

  1. Should allocate resources in a way that fairly distributes benefits and burdens among the members.
  2. Have a duty to present information honestly and are obligated to honor commitments.
  3. Are obligated not to harm their members.
  4. Should treat each plan member in a manner that respects his or her goals and values.

Answer(s): C






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