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An IPO is a corporate umbrella for the management of diversified healthcaredelivery systems. The system may include one or more hospitals, a large grouppractice and other healthcare operations. Physicians practice as employees ofthe organization or in a closely affiliated physician group.Question 4ACOs are similar to HMOs in that they have shared risks. They do have differences – whichstatement is TRUE?SelectedAnswer:The ACO is formed with only 5,000 lives instead of HMOs that generally havehundreds of thousands of lives.4 out of 4 points4 out of 4 pointsReview Test Submission: Chapter 2 Review – MBC-201-900 -......2 of 118/4/17, 6:59 PM
Answers:ACOs requires a five-year commitmentBoth HMOs and ACOs function as an insurance company.The ACO is formed with only 5,000 lives instead of HMOs that generally havehundreds of thousands of lives.ACO’s are performance based while HMO’s are notResponseFeedback:CMS has established that an ACO is responsible for only 5,000 lives, andrequires a minimum of a three-year commitment. ACOs do not function asinsurance companies. Question 5The Protecting Patients and Affordable Care Act (PPACA) is a federal mandate which establishesthat coverage can no longer be denied for _______.Selected Answer:Pre-existing conditionsAnswers:Being unemployedPre-existing conditionsHaving other coverageHaving high medical costs ResponseFeedback:PPACA stipulates that coverage cannot be denied for pre-existing conditions,maternity care, newborn care, mental health services, and preventive care. Question 6What Medicaid services are eligible for reimbursement for an individual that is not a citizen ordoes not have eligible immigration status? Selected Answer:No services are coveredAnswers:No services are coveredAll services are coveredEmergency servicesOutpatient services onlyResponseFeedback:To be eligible for Medicaid an applicant must be a US citizen or provide proofof immigration status unless applying for Emergency services. 4 out of 4 points0 out of 4 points4 out of 4 pointsReview Test Submission: Chapter 2 Review – MBC-201-900 -......3 of 118/4/17, 6:59 PM
Question 7Which type of HMO contracts with multiple specialty groups, individual practice groups, andindividual physicians?Selected Answer:Network Model HMOAnswers:Group Model HMOMixed Model HMONetwork Model HMOHybrid Model HMOResponseFeedback:A Network Model HMO is an HMO that contracts with more than one multi-specialty group, individual practice groups and individual physicians so avariety of services may be offered to its members.Question 8Which of the following statements is true regarding the key provisions of coverage under theAffordable Care Act (ACA)?