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AHM-520 Exam Dumps : Health Plan Finance and Risk Management

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Health Plan Finance and Risk Management Questions and Answers

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Question 1

The physicians who work for the Sunrise Health Plan, a staff model HMO, are paid a salary that is not augmented with another type of incentive plan. Compared to the use of a traditional reimbursement method, Sunrise's use of a salary reimbursement method is more likely to

Options:

A.

Encourage Sunrise's physicians to perform services that are not medically necessary

B.

Completely eliminate service risk for Sunrise's physicians

C.

Decrease Sunrise's liability for any negligent acts of the physicians in the plan's network of providers

D.

Help stabilize expenses for Sunrise

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Question 2

One difference between the internal and external analysis of a health plan's financial information is that

Options:

A.

Internal analysis of the health plan can be more detailed and more specific than can external analysis

B.

Internal analysts are more likely than external analysts to want comparative financial data about the health plan

C.

Only internal analysts use trend analysis to analyze the health plan's financial statements

D.

Only internal analysts typically conduct the financial analysis of the health plan themselves

Question 3

Mandated benefit laws are state or federal laws that require health plans to arrange for the financing and delivery of particular benefits. Within a market, the implementation of mandated benefit laws is likely to cause __________.

Options:

A.

A reduction in the number of self-funded healthcare plans

B.

An increase in the cost to the health plans

C.

A reduction in the size of the provider panels of health plans

D.

A reduction in the uniformity among the healthcare plans of competing health plans

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