HSM340 Quiz Week 7

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HSM340 Quiz Week 7
(TCO 7) A nursing home contracts with an HMO for skilled nursing care at $2.00…

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HSM340 Quiz Week 7

HSM340 Quiz Week 7

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(TCO 7) Coordination of benefits refers to:

A penalty assessed for going out of network

Assessing payment responsibility when multiple payers exist

Benefit plan list of covered services

Vertical integration of health plans

(TCO 7) Capitation plans are more common for physician payment because:

They can better control utilization

Physicians want more risk in their payment plans

They are concerned about adverse selection

Physicians have larger reserves and can assume more risk

(TCO 7) Employer premium costs for health care coverage are often lowest in which type of health plan:

HMO

PPO

POS

High deductible health plans with savings options

(TCO 7) Suppose that AT&T had made an offer to acquire Merck Pharmaceuticals. Ignoring potential antitrust problems, this merger would be classified as a:

Cross-border merger

Horizontal merger

Conglomerate merger

Vertical merger

(TCO 7) A nursing home contracts with an HMO for skilled nursing care at $2.00 PMPM. If costs are expected to average $120 per day, what is the maximum utilization of days per 1,000 members that the nursing home can experience before it begins to lose money?

(TCO 7) A hospital incurs $10 million of cost to treat Medicaid patients and receives $7 million in payment. Actual charges for these Medicaid patients were $20 million. The net community benefit expense that would be reported in Schedule H of IRS Form 990 would be?

(TCO 7) Why is tax-exempt financing cited as a benefit received by not-for-profit healthcare providers?