AHIP AHM-250 - Healthcare Management: An Introduction

One ethical principle in health plans is the principle of non-malfeasance, which holds that health plans and their providers:

Patrick Flaherty's employer has contracted to receive healthcare for its employees from the Abundant Healthcare System. Mr. Flaherty visits his primary care physician (PCP), who sends him to have some blood tests. The PCP then refers Mr. Flaherty to a special

The following programs are part of the Alcove Health Plan's utilization management (UM) program:

Preventive care initiatives

A telephone triage program

A shared decision-making program

A self-care program

With regard to the UM programs, it is most

One way that MCOs involve providers in risk sharing is by retaining a percentage of the providers' payment during a plan year. At the end of the plan year, the MCO may use the amount retained to offset or pay for any cost overruns for referral or hospital

The Conquest Corporation contracts with the Apex health plan to provide basic medical and surgical services to Conquest employees. Conquest entered into a separate contract with the Bright Dental Group to provide and manage a dental care program for employee

Specialty services with certain characteristics tend to make good candidates for health plan approaches. One characteristic used to identify a specialty service that may be a good candidate for a health plan approach is that the service should have

The Blaine Healthcare Corporation seeks to manage its quality by first identifying the best practices and best outcomes for a given procedure. Blaine can then determine areas in which it can emulate the best practices in order to equal or surpass the best

The following sentence contains an incomplete statement with two missing words. Select the answer choice that contains the words that correctly fill in the missing blanks.

At its core, consumer choice involves empowering healthcare consumers to play a __

One device that PBM plans use to manage both the cost and use of pharmaceuticals is a formulary. A formulary is defined as

Individuals can use HSAs to pay for the following types of health coverage:.