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Health Care True/False

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Question;Under a payment;arrangement in which physicians are paid a fixed salary and performance-based;bonuses, risk is shifted from the MCO to the physiciansUnder a payment;arrangement in which physicians are paid a fixed salary and performance-based;bonuses, risk is shifted from the MCO to the physiciansThe percentage;of premium spent on administration, marketing, and profits is the medical loss;ratioThe HMO Act of;1973 had failed to achieve its objective of creating 1,700 HMOsAll MCOs are;now required to be accredited by the National Committee for Quality Assurance.Utilization is;better controlled under a closed-panel plan than under an open-panel plan.Case management;is mainly recommended for patients who need secondary and tertiary care more;often than primary care.Disease;management is highly individualized.One;distinguishing feature of HMOs is that they use discounted fees as the primary;method of paying providers.By law, an HMO is prohibited from having an exclusive;contract with a group practice.In the IPA model, the IPA rather than the HMO contracts;with the physicians.The majority of Medicaid beneficiaries are enrolled in;managed care.In the 1990s, managed care was widely credited for;enabling small employers to offer health insurance coverage to their employees.Research shows that quality of care has declined as;managed care has continued to grow.The objective of horizontal integration is to control;the geographic distribution of a service.Diversification is not achieved through horizontal;integration.

 

Paper#58575 | Written in 18-Jul-2015

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