Question

According to the text, which statement or statements regarding managed care is/are correct? (Level 2)

Group of answer choices

a. While both Medicare and Medicaid beneficiaries may enroll in managed care, few Medicaid beneficiaries do so.

b. Managed care has now become a mature health care delivery model.

c. Mandatory enrollment in Medicare now exists in most states.

d. Managed care has not yet experienced a backlash.

e. None of the above

Ingland, Nicole, Faria, and Bob are talking about MCOs. Ingland says that MCOs sometimes use gatekeeping. Nicole says MCOs use utilization review. Faria mentions that MCOs also use pre-certification and discharge planning. Bob says MCOs use capitation. Who is correct? (Level 2)

Group of answer choices

a. Ingland

b. Nicole

c. Faria

d. Bob

e. None of the above

f. All of the above are correct

The general public often charges the health care industry with seeking to exploit consumers in order to earn more profit. This assumption is an incorrect one. For example, under the ACA, MCOs are not allowed to retain more than __% of the premium dollar to manage risk and to cover its own administrative expenses. (Level 1)

Group of answer choices

a. 15-20%

b. 5-10%

c. 35-45%

d. 3-5%

Thao, Karen and Jennifer were reviewing their group members' contributions to the Final Project. One group member had written the statement that "MCOs are not allowed to operate their own clinics." Which statement or statements below are correct regarding this statement? (Level 1)

Group of answer choices

a. Thao says that MCOs are allowed to operate their own clinics.

b. Karen says that MCOs are not allowed to operate their own clinics.

c. Jennifer says that the operatiuon of MCO clinics is mandatory for all MCOs.

d. None of the above are correct.

According to the text, MCOs have three main types of payments. Which payment method below is not one of these. (Level 1)

Group of answer choices

a. capitation

b. discounted fee

c. salaries

d. commissions on dollars earned

e. All of the above are types of payments

Ms. Heidi and Dr. Betty are doing a presentation to a group of politicians. Which statement below would be one that they could correctly make based on the text regarding the enrollment levels of HMOs by the end of the 1970s? (Level 1)

Group of answer choices

a. HMOs had enrolled between 2-3 million members only

b. HMOs had enrolled between 100,000 and 200,000 members only

c. HMOs had enrolled less than 10 million members

d. HMOs had enrolled more than 10 million members

Answer 1

1) The correct options are :-

a. While both Medicare and Medicaid beneficiaries may enroll in managed care, few Medicaid beneficiaries do so.

b. Managed care has now become a mature health care delivery model.

c. Mandatory enrollment in Medicare now exists in most states.

2) The correct option is F) All of the above are correct

3) The correct option is b) 5-10%

4) The correct option is b)

b. Karen says that MCOs are not allowed to operate their own clinics.

5) The correct option is a,b,c

MCOs use three main types of payment arrangements with providers: capitation, discounted fees, and salaries