AHIP Exam AHM-530 Topic 5 Question 84 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 84
Topic #: 5

The Medicaid program subsidizes indigent care through payments to disproportionate share hospitals (DSHs). The Preamble Hospital is a DSH. As a DSH, Preamble most likely:

AReceives financial assistance from the federal government but not a state government.

BIs at a higher risk of operating at a loss than are most other hospitals.

CReceives no payments directly from Medicaid for services rendered but rather receives a portion of the capitation payment that Medicaid makes to the health plans with which Preamble contracts.

DIs eligible for capitation rates that are significantly higher than the FFS average for all covered Medicaid services.

Show Suggested Answer

Suggested Answer: B

by Candida at Apr 13, 2024, 07:43 AM

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Fannie

7 days ago

Ooh, that's a good point. I hadn't considered the capitation angle. But then again, I thought DSHs didn't get direct Medicaid payments, they just got a share of the overall pool of DSH funds. So maybe C is the way to go?

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Quentin

9 days ago

Hmm, I'm not so sure about that. I was thinking maybe answer D, that DSHs are eligible for higher capitation rates from Medicaid. That would make sense to help cover their increased costs, right?

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Orville

10 days ago

Yeah, no kidding. But I think that's the whole point of the DSH program - to help offset the financial burden on hospitals that are caring for the most vulnerable patients. I'm leaning towards answer B, that DSHs are at higher risk of operating at a loss.

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Leanna

11 days ago

Haha, I bet the insurance companies love dealing with DSHs. Probably a lot of red tape and bureaucracy involved in getting those payments.

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Derrick

13 days ago

I agree, this is definitely a tricky one. From what I know, DSHs are hospitals that serve a significantly higher proportion of low-income patients, so they're more likely to operate at a loss. But I'm not sure about the specifics of the payments they receive.

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Cheryll

15 days ago

Hmm, this question is asking about the Medicaid program and how it relates to disproportionate share hospitals (DSHs). I think the key is understanding what a DSH is and how it differs from other hospitals in terms of government assistance and financial risk.

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