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Ace Your AHM-520 AHIP Certification Exam

Page: 6 / 8
Total 215 questions

Health Plan Finance and Risk Management Questions and Answers

Question 21

The Jade Health Plan used a profitability index (PI) to rank the following capital proposals:

Proposal PI

A0.45

B1.05

This information indicates that, of these two projects, Jade would most likely select:

Options:

A.

Proposal A, and the PI indicates that the net present value (NPV) for this project is less than zero

B.

Proposal A, and the PI indicates that the net present value (NPV) for this project is greater than zero

C.

Proposal B, and the PI indicates that the net present value (NPV) for this project is less than zero

D.

Proposal B, and the PI indicates that the net present value (NPV) for this project is greater than zero

Question 22

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

Question 23

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 24

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

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Total 215 questions