Healthcare Management: An Introduction: AHM-250

Health plans sometimes contract with independent organizations to provide specialty services, such as vision care or rehabilitation services, to plan members. Specialty services that have certain characteristics are generally good candidates for health pl

A. Low or stable costs.

B. Appropriate, rather than inappropriate, utilization rates.

C. A benefit that cannot be easily defined.

D. Defined patient population.

The following statements describe common types of physician/hospital integrated models:

The Iota Company, which is owned by a group of investors, is a for-profit legal entity that buys entire physician practices, not just the tangible assets of the practice

A. Iota- physician hospital organization (PHO)Casa- physician practice management (PPM) company.

B. Iota- physician hospital organization (PHO)Casa- medical foundation.

C. Iota- physician practice management (PPM) Casa- physician hospital organization (PHO) company.

D. Iota- medical foundation Casa- management services organization (MSO).

The Neptune Hospital provides medical care to paying patients, as well as to people who either have no healthcare coverage and cannot afford to pay for the care by themselves or who receive services at reduced rates because they are covered under govern me

A. cost shifting

B. Anti selection

C. receivership

D. Underwriting