An IPO is a corporate umbrella for the management of diversified healthcare
delivery systems. The system may include one or more hospitals, a large group
practice and other healthcare operations. Physicians practice as employees of
the organization or in a closely affiliated physician group.
Question 4
ACOs are similar to HMOs in that they have shared risks.
They do have differences – which
statement is TRUE?
Selected
Answer:
The ACO is formed with only 5,000 lives instead of HMOs that generally have
hundreds of thousands of lives.
4 out of 4 points
4 out of 4 points
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Answers:
ACOs requires a five-year commitment
Both HMOs and ACOs function as an insurance company.
The ACO is formed with only 5,000 lives instead of HMOs that generally have
hundreds of thousands of lives.
ACO’s are performance based while HMO’s are not
Response
Feedback:
CMS has established that an ACO is responsible for only 5,000 lives, and
requires a minimum of a three-year commitment. ACOs do not function as
insurance companies.
Question 5
The Protecting Patients and Affordable Care Act (PPACA) is a federal mandate which establishes
that coverage can no longer be denied for _______.
Selected Answer:
Pre-existing conditions
Answers:
Being unemployed
Pre-existing conditions
Having other coverage
Having high medical costs
Response
Feedback:
PPACA stipulates that coverage cannot be denied for pre-existing conditions,
maternity care, newborn care, mental health services, and preventive care.
Question 6
What Medicaid services are eligible for reimbursement for an individual that is not a citizen or
does not have eligible immigration status?
Selected Answer:
No services are covered
Answers:
No services are covered
All services are covered
Emergency services
Outpatient services only
Response
Feedback:
To be eligible for Medicaid an applicant must be a US citizen or provide proof
of immigration status unless applying for Emergency services.
4 out of 4 points
0 out of 4 points
4 out of 4 points
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Question 7
Which type of HMO contracts with multiple specialty groups, individual practice groups, and
individual physicians?
Selected Answer:
Network Model HMO
Answers:
Group Model HMO
Mixed Model HMO
Network Model HMO
Hybrid Model HMO
Response
Feedback:
A Network Model HMO is an HMO that contracts with more than one multi-
specialty group, individual practice groups and individual physicians so a
variety of services may be offered to its members.
Question 8
Which of the following statements is true regarding the key provisions of coverage under the
Affordable Care Act (ACA)?
