Free AHM-250 Exam Dumps

Question 6

- (Topic 1)
Before the Hill Health Maintenance Organization (HMO) received a certificate of authority (COA) to operate in State X, it had to meet the state's licensing requirements and financial standards which were established by legislation that is identical to the

A. Receive compensation based on the volume and variety of medical services they perform for Hill plan members, whereas the specialists receive compensation based solely on the number of plan members who are covered for specific services.
B. Have no financial incentive to practice preventive care or to focus on improving the health of their plan members, whereas the specialists have a positive incentive to help their plan members stay healthy.
C. Receive from the IPA the same monthly compensation for each Hill plan member under the PCP's care, whereas the specialists receive compensation based on a percentage discount from their normal fees.
D. Receive compensation based on a fee schedule, whereas the specialists receive compensation based on per diem charges.

Correct Answer:C

Question 7

- (Topic 2)
Several marketplace factors helped fuel the movement toward consumer choice. Which one of the following statements is NOT accurate with regard to these factors?

A. After a period of relative stability, annual growth in private health spending per capita began to increase rapidly in 2002.
B. During the height of the recent cost upswing, insurance premiums were increasing by more than 13% annually.
C. Increased utilization was the largest factor contributing to the rise in premiums, accounting for 43% of the increase.
D. Employer payers began seeking ways to control spiraling utilization rates and provide lower cost health coverage options.

Correct Answer:A

Question 8

- (Topic 2)
The following programs are part of the Alcove Health Plan's utilization management (UM) program:
✑ Preventive care initiatives
✑ A telephone triage program
✑ A shared decision-making program
✑ A self-care program
With regard to the UM programs, it is most

A. Preventive care initiatives include immunization programs but not health promotion programs.
B. Telephone triage program is staffed by physicians only.
C. Shared decision-making program is appropriate for virtually any medical condition.
D. Self-care program is intended to complement physicians' services, rather than to supersede or eliminate these services.

Correct Answer:D

Question 9

- (Topic 1)
From the following answer choices, choose the description of the ethical principle that best corresponds to the term Beneficence

A. Health plans and their providers are obligated not to harm their members
B. Health plans and their providers should treat each member in a manner that respects the member's goals and values, and they also have a duty to promote the good of the members as a group
C. Health plans and their providers should allocate resources in a way that fairly distributes benefits and burdens among the members
D. Health plans and their providers have a duty to respect the right of their members to make decisions about the course of their lives

Correct Answer:B

Question 10

- (Topic 2)
Member satisfaction is a critical element of a health plan's quality management program. A health plan can obtain information about member satisfaction with various aspects of the
health plan from

A. surveys completed by members following a visit to a provider
B. surveys sent to plan members who have not received healthcare services during a specified time period
C. periodic reports of complaints received by member services personnel
D. all of the above

Correct Answer:D