Free AHM-520 Exam Dumps

Question 51

- (Topic 2)
The amount of risk for health plan products is dependent on the degree of influence and the relationships that the health plan maintains with its providers. Consider the following types of managed care structures:
✑ Preferred provider organization (PPO)
✑ Group model HMO
✑ Staff model health maintenance organization (HMO)
✑ Traditional health insurance
Of these health plan products, the one that would most likely expose a health plan to the highest risk is the:

A. preferred provider organization (PPO)
B. group model HMO
C. staff model health maintenance organization (HMO)
D. traditional health insurance

Correct Answer:C

Question 52

- (Topic 1)
The Zane health plan uses a base of accounting known as accrual-basis accounting. With regard to this base of accounting, it can correctly be stated that accrual-basis accounting

A. Enables an interested party to view the consequences of obligations incurred by Zane, but only if the health plan ultimately completes the business transaction
B. Is not suitable for measuring Zane's profitability
C. Requires Zane to record revenues when they are earned and expenses when they are incurred, even if cash has not actually changed hands
D. Prohibits Zane from making adjusting entries to its accounting records at the end of each accounting year

Correct Answer:C

Question 53

- (Topic 2)
The following statements are about rate ratios used by health plans. Select the answer choice containing the correct statement:

A. While rate ratios consider family size, they are most often based on competitive factors, such as the ratios being used by competitors and the ratios that plan sponsors are requesting.
B. If the rate ratio for a couple rate category is 2.0, then the single premium is divided by 2.0 to derive the couple rate category premium.
C. A rate ratio can only be increased if the health plan has obtained regulatory approval.
D. The effect of a typical family rate ratio is that a family rate is somewhat higher than it otherwise should be, and the single rate is somewhat lower that it otherwise should be.

Correct Answer:A

Question 54

- (Topic 1)
The following statements are about carve-out programs. Three of these statements are true, and one statement is false. Select the answer choice containing the FALSE statement.

A. In the type of carve-out in which entire categories of care are administered by independent organizations, a health plan typically reimburses these organizations under an FFS contract.
B. Typically, a health plan will offer carved-out services to its enrollees, but will manage these services separately.
C. Carve-outs are services that are excluded from a capitation payment, a risk pool, or a health benefit plan.
D. The most rapidly growing area related to carve-outs is disease management (DM).

Correct Answer:A

Question 55

- (Topic 2)
Analysts will use the capital asset pricing model (CAPM) to determine the cost of equity for the Maxim health plan, a for-profit plan. According to the CAPM, Maxim's cost of equity is equal to

A. The average interest rate that Maxim is paying to debt holders, adjusted for a tax shield
B. Maxim's risk-free rate minus its beta
C. Maxim's risk-free rate plus an adjustment that considers the market rate, at a given level of systematic (non diversifiable) risk
D. Maxim's risk-free rate plus an adjustment that considers the market rate, at a given level of nonsystematic (diversifiable) risk

Correct Answer:C