Which is associated with contracted health care services that are delivered to subscribers by participating physicians who are members of an independent multispecialty group practice?
a. direct contract model HMO
b. group model HMO
c. network model HMO
d. staff model HMO
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Q. 2) Which is associated with health care that is provided by individuals who are not employees of the HMO or who do not belong to a specially formed medical group that serves the HMO?
a. closed-panel HMO
b. open-panel HMO
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Q. 3) Which is associated with health care that is provided in an HMO-owned center or satellite clinic or by physicians who belong to a specially formed medical group that serves the HMO?
a. closed-panel HMO
b. open-panel HMO
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Q. 4) A health maintenance organization (HMO) is an alternative to traditional group health insurance coverage and provides comprehensive health care services to voluntarily enrolled members on a __________ basis.
a. fee-for-service
b. per diem
c. prepaid
d. retrospective
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Q. 5) A medical foundation is a nonprofit organization that contracts with and __________ the clinical and business assets of physician practices.
a. acquires
b. indentures
c. leases
d. liquidates
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Q. 6) An integrated provider organization (IPO) manages the delivery of health care services offered by hospitals, physicians, and other health care organizations. Physicians associated with an IPO are considered __________.
a. employees
b. independent contractors
c. self-employed
d. temporary staff
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Q. 7) A group practice without walls (GPWW) establishes a contract that allows physicians to maintain their own offices and share services, such as __________.
a. admitting patients to the hospital
b. appointment scheduling and billing
c. performing surgical procedures
d. providing office services to patients
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Q. 8) A management service organization (MSO) is usually owned by physicians or a hospital and provides practice management (administrative and support) services to __________.
a. government health programs
b. individual physician practices
c. managed care organizations
d. third-party payers
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Q. 9) A physician-hospital organization (PHO) is owned by hospital(s) and physician groups that
obtain managed care plan contracts. The physicians __________ and provide health care services to plan members.
a. are employed by the PHO
b. calculate what they want to earn
c. maintain their own practices
d. purchase the PHO building
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Q. 10) An integrated delivery system (IDS) is an organization of __________ that offer
joint health care services to subscribers.
a. affiliated providers' sites
b. government agencies
c. nonparticipating providers
d. third-party payers
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