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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

Question 1

The types of financial risks and costs to which a health plan is subject depends on whether the health plan provides services to the Medicare and/or Medicaid populations or to the commercial population. One distinction between providing services to the Medicare and Medicaid populations and to the commercial population is that Medicare and Medicaid enrollees typically:

Options:

A.

Are locked into a plan for a 12-month period, whereas enrollees from the commercial population may disenroll from a plan on a monthly basis

B.

Require less enrollee education than do enrollees from the commercial population

C.

Have higher incidences of chronic illness than do enrollees from the commercial population

D.

Are enrolled in a health plan through a group situation, whereas the commercial population typically enrolls in a health plan on an individual basis

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Question 2

A health plan most likely would use benchmarking in order to

Options:

A.

Measure its performance and practices against those of other companies to help identify those practices that will lead to superior performance in a variety of financial and non-financial areas

B.

Calculate the percentage changes in its financial statement items over several consecutive accounting periods

C.

Determine both the direction and velocity of trends in its financial statements

D.

Display only percentage relationships in its financial statements

Question 3

The Savanna health plan used a risk analysis technique which defines the key assumptions of Savanna's strategic financial plan in terms of mathematical formulas that can be correlated to each other or analyzed independently. This technique allowed Savanna to simulate probable future events on a computer and produce a distribution of possible outcomes. This risk analysis technique, which can be used to predict Savanna's distribution of expected claims, is known as

Options:

A.

A hurdle rate simulation

B.

Optimistic, most likely, pessimistic scenario modeling

C.

A Monte Carlo simulation

D.

Debt covenant modeling