One true statement about community rating, a rating method commonly used by health plans, is that:

It requires a health plan to set premiums for financing medical care according to the health plan's expected cost of providing medical benefits to a sub-group within the community.
A health plan usually uses community rating to set premiums for large groups.
It tends to lead to greater fluctuations in premium rates than do other rating methods.
A health plan seldom uses community rating to set premiums for large groups.

Answer(s): D

One true statement regarding ethics and laws is that the values of a community are reflected in

both ethics and laws, and both ethics and laws are enforceable in the court system
both ethics and laws, but only laws are enforceable in the court system
ethics only, but only laws are enforceable in the court system
laws only, but both ethics and laws are enforceable in the court system

Answer(s): B

One type of physician-only integration model is a consolidated medical group. Typical characteristics of a consolidated medical group include

Answer(s): D

One typical characteristic of an integrated delivery system (IDS) is that an IDS.

Is more highly integrated structurally than it is operationally.
Provides a full range of healthcare services, including physician services, hospital services, and ancillary services.
Cannot negotiate directly with health plans, plan sponsors, or other healthcare purchasers.
Performs a single business function, such as negotiating with health plans on behalf of all of the member providers.

Answer(s): B

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