Posted: November 25th, 2022

Health care true/false | Marketing homework help

  • Under a payment arrangement in which physicians are paid a fixed salary and performance-based bonuses, risk is shifted from the MCO to the physicians

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  • Under a payment arrangement in which physicians are paid a fixed salary and performance-based bonuses, risk is shifted from the MCO to the physicians

  • The percentage of premium spent on administration, marketing, and profits is the medical loss ratio

  • The HMO Act of 1973 had failed to achieve its objective of creating 1,700 HMOs

  • All MCOs are now required to be accredited by the National Committee for Quality Assurance.

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  • 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.

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