Ace the AHIP AHM-250 Exam: Ultimate Preparation Guide

Ms. Novacek, Mr. Rashad, and Mr. Devereaux

Ms. Novacek and Mr. Rashad only

Ms. Novacek and Mr. Devereaux only

None of these members

Transfer all of the HMO's business to other carriers.

Allow the state commissioner, acting for a state court, to take control of and administer the HMO's assets and liabilities.

Sell the HMO's assets in order to satisfy the HMO's obligations.

Place the HMO's operations under the direction and control of the state commissioner or a person appointed by the commissioner.

receive compensation based on the volume and variety for medical services they perform for Leo plan members, whereas the specialists receive compensation based solely on the number of plan members who are covered for specific services

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

receive from the IPA the same monthly compensation for each Leo plan member under the PCP's care, whereas the specialists receive compensation based on a percentage discount from their normal fees

receive compensation based on a fee schedule, whereas the specialists receive compensation based on per diem charges

$525

$1,050

$2,100

$5,250

dual choice

cost shifting

accreditation

defensive medicine

Confinement in the extended-care facility after his hospitalization.

Transportation by ambulance from the hospital to the extended-care facility.

Physicians' professional services while he was hospitalized.

physicians' professional services while he was at the extended-care facility.

verification of a network provider's medical education and residency

performance of site inspections in a provider's facilities

review of information from a provider's quality improvement activities

verification of a provider's licensure and certification

organizations and individuals involved in the consumption of healthcare provided by the plan

relative accessibility of the plan's providers to the plan's participants

group of physicians, hospitals, and other medical care providers with whom the plan has contracted to deliver medical services to its members

integration of the plan's participants with the plan's providers

Network model HMO

Group model HMO

Staff model HMO

Mixed model HMO

Hospital observation units or psychiatric hospitals.

Psychiatric hospitals or rehabilitation hospitals.

Subacute care facilities or skilled nursing facilities.

Psychiatric units in general hospitals or hospital observation units.