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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

A health plan that capitates a provider group typically provides or offers to provide stop-loss coverage to that provider group.

Options:

A.

True

B.

False

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Question 2

The following statements are about a health plan's evaluation of its responsibility centers. Select the answer choice containing the correct statement.

Options:

A.

When analyzing budget variances, a health plan's management should pay attention to unfavorable variances only.

B.

A health plan can reduce the problem of unattainable goals by involving responsibility managers in the preparation of their centers' budgets.

C.

One reason that a health plan would use cost-based transfer prices to evaluate the performance of its profit centers and investment centers is because, under this method of setting transfer prices, the selling center has maximum incentive to operate effectively and control costs.

D.

In responsibility accounting, all employees who have any influence over a health plan's department are held equally accountable for the operations and financial outcomes of that department.

Question 3

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