The nurse is working with a case manager for a client who participates in a health maintenance organization.
The nurse should identify which of the following payment structures?
The provider is paid a fixed sum for the client on a monthly or yearly basis.
The client is participating in a fee-for-service healthcare insurance program. The provider bills the client directly for a predetermined percentage of the cost of services.
The client pays the insurer a percentage of the total costs for each service rendered by the provider.
None of the above (This option is necessary because there are only three options provided in the original question).
The Correct Answer is A
The provider is paid a fixed sum for the client on a monthly or yearly basis. This payment structure is known as capitation. In a health maintenance organization (HMO), the provider is paid a fixed amount per enrolled member per month or year, regardless of the services provided.
Choice B is not the answer because it describes a fee-for-service healthcare insurance program, which is different from an HMO.
Choice C is not the answer because it describes a co-insurance payment structure, which is also different from an HMO.
Choice D is not the answer because it states that none of the above choices are correct.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Primary prevention strategies aim to prevent a problem before it occurs. Teaching parenting techniques to new parents is a primary prevention strategy because it helps to prevent individual and family violence by providing new parents with the skills and knowledge they need to raise their children in a healthy and non-violent environment.
Choice A is not correct because providing treatment for a young adult who has a substance use disorder is a secondary prevention strategy.
It aims to reduce the impact of a problem that has already occurred.
Choice B is not correct because assessing a family for marital discord is also a secondary prevention strategy.
Choice C is not correct because conducting counseling for at-risk parents is a tertiary prevention strategy.
It aims to reduce the impact of an ongoing problem and prevent it from getting worse.
Correct Answer is C
Explanation
Organize an influenza immunization clinic with the American Red Cross.
This action can help address the primary healthcare needs of the congregation by providing preventative care.
Choice A is not an answer because facilitating discharge from a facility to the home is not a service typically provided by a parish nurse group.
Choice B is not an answer because performing wound care in the home of members is not a service typically provided by a parish nurse group.
Choice D is not an answer because providing end-of-life care for members who are terminal is not a service typically provided by a parish nurse group.
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