What was the main purpose of the Health Maintenance Organization Act of 1973?
Place caps on the rise of health insurance premiums
Transfer the control of HMOs from the federal government to private companies
Rein in the growing power of managed care
Provide an alternative to fee-for-service
The Correct Answer is D
Rationale:
A. Place caps on the rise of health insurance premiums: This option does not align with the main purpose of the Health Maintenance Organization (HMO) Act of 1973, which aimed to promote
the development of HMOs as an alternative to traditional fee-for-service models rather than directly addressing insurance premiums.
B. Transfer the control of HMOs from the federal government to private companies: The HMO Act of 1973 aimed to encourage the establishment of HMOs by providing federal grants and
loans, but it did not involve transferring control from the government to private companies.
C. Rein in the growing power of managed care: The HMO Act of 1973 actually facilitated the growth of managed care by providing federal support for the establishment of HMOs, rather than attempting to rein in their power.
D. Provide an alternative to fee-for-service: The primary purpose of the HMO Act of 1973 was to promote and facilitate the development of Health Maintenance Organizations (HMOs) as an
alternative healthcare delivery model to traditional fee-for-service arrangements. HMOs were intended to emphasize preventive care, cost containment, and coordination of services.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Chronic disease prevention and management: While chronic diseases can contribute to healthcare costs, they are not directly related to waste and abuse within the healthcare system.
B. Fraud: Fraudulent activities, such as billing for services not provided or submitting false
claims, contribute to waste and abuse in the healthcare system, leading to higher costs for payers and consumers.
C. Unequal access to health care: Unequal access to healthcare may lead to disparities in health outcomes and healthcare utilization but is not necessarily a direct cause of waste and abuse.
D. Competitive approaches: Competitive approaches may influence healthcare delivery models and pricing strategies but are not directly related to waste and abuse contributing to rising
healthcare costs.
Correct Answer is A
Explanation
Rationale:
A. Car model: The "Car model" is not a recognized model of Health Maintenance Organization (HMO). It seems to be a distractor in this context.
B. Network model: In the network model, the HMO contracts with multiple independent medical groups or practices to provide healthcare services to its members.
C. Group model: In the group model, the HMO contracts with a single medical group, which employs physicians and provides healthcare services to HMO members.
D. Staff model: In the staff model, the HMO directly employs physicians and other healthcare providers who deliver services to its members.
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