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AHIP AHM-520 Exam - Topic 6 Question 73 Discussion

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

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

Suggested Answer: C

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40 comments · newest first
GL
Gladys 11 months ago
Interesting! I didn't realize PPOs had that much responsibility.
PA
Paris 12 months ago
Nope, PBMs manage drug benefits, not overall healthcare risk.
LO
Louisa 12 months ago
Wait, are you sure about that? I thought TPAs handled the risk.
CY
Cyndy 1 year ago
Totally agree, PPOs are the way to go for flexibility!
FR
Francoise 1 year ago
PPOs usually take on financial risk for healthcare costs.
DE
Delisa 1 year 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!
KA
Kallie 1 year ago
I practiced a question similar to this, and I think it was about how PPOs negotiate with providers. That might be relevant here.
DI
Dick 1 year ago
I feel like TPAs don't actually assume financial risk; they just administer the plans. I might be confusing them with something else.
RI
Rickie 1 year 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.
AJ
Aja 1 year 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.
AD
Adaline 1 year 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.
RE
Reta 1 year 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.
LO
Lottie 2 years 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!
EV
Evangelina 1 year ago
↳ replying to Lottie
D) Pharmacy benefit management (PBM) plan
CO
Cordell 1 year ago
↳ replying to Lottie
A) Third party administrator (TPA)
LI
Lili 1 year ago
↳ replying to Lottie
C) Preferred provider organization (PPO)
HY
Hyman 2 years 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!
HO
Hobert 1 year ago
↳ replying to Hyman
Yeah, PPO plans are a popular choice for many people.
CO
Corazon 1 year ago
↳ replying to Hyman
TPAs are more about administrative services, not financial risk.
MA
Ma 1 year ago
↳ replying to Hyman
I think PPO plans are more flexible with providers too.
XU
Xuan 1 year ago
↳ replying to Hyman
I agree, PPO plans definitely take on the financial risk.
JA
Jani 1 year ago
↳ replying to Hyman
PBM plans focus more on managing prescription drug benefits.
BI
Billye 1 year ago
↳ replying to Hyman
TPA plans are also common in managing healthcare benefits.
LA
Lai 1 year ago
↳ replying to Hyman
I think PPO plans are a good choice for those who want more flexibility in choosing healthcare providers.
LA
Lakeesha 1 year ago
↳ replying to Hyman
I agree, PPO plans definitely take on the financial risk.
XU
Xuan 1 year ago
↳ replying to Hyman
PPO plans are known for assuming the financial risk in healthcare benefits.
NI
Nikita 1 year ago
↳ replying to Hyman
I think PPO plans are the way to go when it comes to assuming financial risk.
VA
Val 1 year ago
↳ replying to Hyman
I agree, PPO plans definitely take on the financial risk.
SH
Shawnee 2 years 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.
PA
Pamella 2 years 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.
KE
Kenda 1 year ago
↳ replying to Pamella
Yes, you are correct. PPO plans typically assume the financial risk of delivering and financing healthcare benefits.
PA
Paul 2 years ago
↳ replying to Pamella
I think the correct answer is C) Preferred provider organization (PPO).
LO
Lon 2 years 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).
TO
Tonette 1 year ago
↳ replying to Lon
UROs focus more on reviewing and managing healthcare utilization, rather than assuming financial risk.
TA
Tashia 1 year ago
↳ replying to Lon
TPAs and PBMs usually do not assume as much financial risk as PPOs.
BO
Bo 2 years ago
↳ replying to Lon
I agree, PPOs typically assume the financial risk of delivering and financing healthcare benefits.
SA
Samuel 2 years ago
↳ replying to Lon
I think the answer is C) Preferred provider organization (PPO).
SI
Silva 2 years ago
I'm not sure about PPOs. I think it could also be A) Third party administrator (TPA) because they handle claims and assume some financial risk.
MA
Margret 2 years ago
I agree with Becky. PPOs negotiate discounts with healthcare providers and assume some financial risk.
BE
Becky 2 years ago
I think the answer is C) Preferred provider organization (PPO). PPOs often assume financial risk.
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