How did managed care organizations (MCOs) garner enormous buying power?
By integration of several organizations under the same ownership or contractual arrangements
By shared savings program under the ACA
By providing an array of health care services to a large community
By enrolling a large segment of the insured population
The Correct Answer is A
A. By integration of several organizations under the same ownership or contractual
arrangements: MCOs garner enormous buying power by integrating various healthcare providers and services under one ownership or through contractual agreements, which allows them to negotiate better rates with suppliers and providers.
B. By shared savings program under the ACA: While the shared savings program under the ACA aims to reduce healthcare costs, it is not the primary method through which MCOs gained their buying power.
C. By providing an array of health care services to a large community: Providing a wide range of services enhances the value offered by MCOs but does not directly lead to significant buying power.
D. By enrolling a large segment of the insured population: Enrolling a large number of insured
individuals helps MCOs spread risk but is not the main factor that provides them with enormous buying power.
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Related Questions
Correct Answer is A
Explanation
A. A nonfederal short-stay hospital whose services are available to the general public: Community hospitals are defined as nonfederal short-stay hospitals that provide a range of services to the general public and are accessible to all members of the community.
B. Nongovernment and privately owned: While many community hospitals may be privately owned, this option does not encompass the full definition as it excludes government-owned hospitals that serve the community.
C. Government ownership (federal, state, or local): Community hospitals can be government- owned, but this answer does not capture the full scope of what defines a community hospital.
D. Often located in large urban areas: Community hospitals can be found in both urban and rural areas, so this answer is not sufficiently inclusive.
Correct Answer is A
Explanation
A. Concurrent: Concurrent utilization review involves the ongoing monitoring of a patient's care and recovery while they are still receiving treatment. This type of review focuses on ensuring that the care provided is appropriate and that the patient is progressing as expected.
B. Preauthorization: Preauthorization involves obtaining approval from a health insurer before a service is provided to ensure it will be covered. It does not focus on monitoring a patient's recovery.
C. Retrospective: Retrospective review involves evaluating the care provided to a patient after the treatment has been completed. It looks at the appropriateness of care but does not monitor ongoing recovery.
D. Prospective: Prospective review involves evaluating the necessity of a treatment before it begins. It does not include ongoing monitoring of a patient's prognosis for recovery.
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