AHIP AHM-520 Exam - Topic 6 Question 73 Discussion

Actual exam question for AHIP's AHM-520 exam

Question #: 73
Topic #: 6

A key factor that distinguishes the various types of health plans is the type and amount of risk that a health plan assumes with respect to the delivery and financing of healthcare benefits. An example of a type of health plan that typically assumes the financial risk of delivering and financing healthcare benefits is a

AThird party administrator (TPA)

BUtilization review organization (URO)

CPreferred provider organization (PPO)

DPharmacy benefit management (PBM) plan

Show Suggested Answer

Suggested Answer: C

by Rikki at Aug 07, 2023, 07:02 PM

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Gladys

5 months ago

Interesting! I didn't realize PPOs had that much responsibility.

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Paris

6 months ago

Nope, PBMs manage drug benefits, not overall healthcare risk.

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Louisa

6 months ago

Wait, are you sure about that? I thought TPAs handled the risk.

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Cyndy

6 months ago

Totally agree, PPOs are the way to go for flexibility!

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Francoise

6 months ago

PPOs usually take on financial risk for healthcare costs.

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Delisa

7 months ago

I’m leaning towards the URO, but I remember they mainly focus on reviewing services rather than taking on financial risk. This is tricky!

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Kallie

7 months ago

I practiced a question similar to this, and I think it was about how PPOs negotiate with providers. That might be relevant here.

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Dick

7 months ago

I feel like TPAs don't actually assume financial risk; they just administer the plans. I might be confusing them with something else.

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Rickie

7 months ago

I think the answer might be PPO, but I'm not entirely sure. I remember something about them managing risk differently than other plans.

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Aja

7 months ago

Okay, let me see. The key factors are likely related to the device's network or hardware properties. I'll start by eliminating the options that don't seem relevant.

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Adaline

7 months ago

I've got a good feeling about this question. The job worth hierarchy is all about establishing the relative value of different roles, which then allows you to group similar jobs and set appropriate compensation levels. I'll confidently select option E as the best answer.

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Reta

7 months ago

Okay, I've got this. The key is remembering that controlling risk involves taking preventative measures, while transferring risk means purchasing insurance to cover potential losses. I'm confident I can get this right.

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Lottie

1 year ago

I wonder if the exam question authors ever get tired of asking about health plans. Maybe they should mix it up with a knock-knock joke or two, just to keep us on our toes!

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Evangelina

11 months ago

D) Pharmacy benefit management (PBM) plan

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Cordell

11 months ago

A) Third party administrator (TPA)

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Lili

11 months ago

C) Preferred provider organization (PPO)

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Hyman

1 year ago

Ah, this one's easy! A PPO plan is the answer, since they're the ones who shoulder the financial risk. Piece of cake!

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Hobert

10 months ago

Yeah, PPO plans are a popular choice for many people.

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Corazon

10 months ago

TPAs are more about administrative services, not financial risk.

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Ma

11 months ago

I think PPO plans are more flexible with providers too.

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Xuan

11 months ago

I agree, PPO plans definitely take on the financial risk.

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Jani

11 months ago

PBM plans focus more on managing prescription drug benefits.

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Billye

11 months ago

TPA plans are also common in managing healthcare benefits.

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Lai

11 months ago

I think PPO plans are a good choice for those who want more flexibility in choosing healthcare providers.

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Lakeesha

11 months ago

I agree, PPO plans definitely take on the financial risk.

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Xuan

11 months ago

PPO plans are known for assuming the financial risk in healthcare benefits.

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Nikita

11 months ago

I think PPO plans are the way to go when it comes to assuming financial risk.

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Val

12 months ago

I agree, PPO plans definitely take on the financial risk.

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Shawnee

1 year ago

Hmm, I was a bit unsure between C and D, but I think C is the right choice. A PPO plan takes on the financial risk, while a PBM plan just manages the pharmacy benefits.

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Pamella

1 year ago

A PPO plan typically assumes the financial risk of delivering and financing healthcare benefits, so C is the correct answer. This is a straightforward question.

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Kenda

12 months ago

Yes, you are correct. PPO plans typically assume the financial risk of delivering and financing healthcare benefits.

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Paul

1 year ago

I think the correct answer is C) Preferred provider organization (PPO).

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Lon

1 year ago

This question is testing our understanding of the different types of health plans and the risk they assume. I think the answer is C) Preferred provider organization (PPO).

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