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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 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.

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Question 2

One true statement about a type of capitation known as a percent-of-premium arrangement is that this arrangement

Options:

A.

Is the most common type of capitation

B.

Is less attractive to providers when the arrangement sets provisions to limit risk

C.

Sets provider reimbursement at a specific dollar amount per plan member

D.

Transfers some of the risk associated with underwriting and rating from a health plan to a provider

Question 3

The provider contract that Dr. Timothy Meyer, a pediatrician, has with the Cardigan health plan states that Cardigan will compensate him under a capitation arrangement. However, the contract also includes a typical low enrollment guarantee provision. Statements that can correctly be made about this arrangement include that the low enrollment guarantee provision most likely:

Options:

A.

Causes Dr. Meyer's capitation contract with Cardigan to transfer more risk to him than the contract otherwise would transfer

B.

Specifies that Cardigan will pay Dr. Meyer under an arrangement other than capitation until a specified number of children covered by the plan use him as their PCP

C.

Both A and B

D.

A only

E.

B only

F.

Neither A nor B