QUESTION: 165

Specialty services that have certain characteristics generally are good candidates for managed care approaches. These characteristics generally include that the specialty service should have

appropriate, rather than inappropriate, utilization
a defined patient population
low, stable costs
a benefit that cannot be easily defined

Answer(s): B

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Specialty services with certain characteristics tend to make good candidates for health plan approaches. One characteristic used to identify a specialty service that may be a good candidate for a health plan approach is that the service should have

a defined patient population
a complex benefit structure
low, stable costs
appropriate utilization rates

Answer(s): A

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QUESTION: 167

The prudent layperson standard described in the Balanced Budget Act (BBA) of 1997 requires all hospitals that receive Medicare or Medicaid reimbursement to screen and, if necessary, stabilize all patients who come to their emergency departments.

True
False

Answer(s): B

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QUESTION: 168

The Acme HMO recruits and contracts directly with a wide range of physicians--both PCPs and specialists--in its geographic area on a non-exclusive basis. There is no separate legal entity that represents and negotiates the contracts for the physicians. The

an independent practice association (IPA) model HMO
a staff model HMO
a direct contract model HMO
a group model HMO

Answer(s): C

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Free AHM-250 Exam Braindumps (page: 43)

QUESTION: 165

QUESTION: 166

QUESTION: 167

QUESTION: 168

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