PDF AHM-250 Study Guide

Healthcare Management: An Introduction Questions and Answers

Question 9

An exclusive provider organization (EPO) operates much like a PPO. However, one difference between an EPO and a PPO is that an EPO

Is regulated under federal HMO legislation

Generally provides no benefits for out-of-network care

Has no provider network of physicians

Is not subject to state insurance laws

Question 10

A common physician-only integrated model is a group practice without walls (GPWW). One characteristic of a typical GPWW is that the

GPWW combines multiple independent physician practices under one umbrella organization

GPWW generally has a lesser degree of integration than does an IPA

member physicians cannot own the GPWW

GPWW's member physicians must perform their own business operations

Question 11

Health plans use the following to determine the number of providers to add to a network:

Staffing ratios

Drive time

Geographic availability

All of the above

Question 12

Beginning in the early 1980s, several factors contributed to increased demand for behavioral healthcare services. These factors included

increased stress on individuals and families

increased availability of behavioral healthcare services

greater awareness and acceptance of behavioral healthcare issues

all of the above