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Course 1C_L2 - Quiz 2

 

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1)
In this lesson, SERIAL Sub-Capitation (sometimes referred to as a Sub-Sub-Cap) is seen as _________________ when compared to regular Capitation or Sub-Capitation contracts.
 
more desirable
less problematic
far superior
definitely 'The Ugly'
sometimes 'The Bad'
 
2)
This question relates to SUB-CAPITATED contracts. Please choose the correct answer below, based upon information presented in this course.
 
The original CAPITATED contractor (such as an HMO or a Behavioral Health Organization - a BHO) passes most (but not all) of the original contract funds down to a second organization.
The original CAPITATED contractor retains or 'rakes off' a certain percentage of the original funds, for its own administrative use.
The original CAPITATED contractor also 'off-loads' its RISK - along with the money - onto the new 'SUB-Capitated' entity.
This is one way that some Managed Care companies (with State approval) control their costs (i.e., protect themselves against losing money on the contract).
All of the above.
 
3)
Because of Federal Regulations, the States have no options in how they design their Managed Health Care Plans.
 
True False
 
4)
Looking at SUB-CAPITATION, this lesson tells us that there _________________ an 'administrative rake-off' of funds before the money and the risk are passed on down to another entity.
 
is not
may sometimes be
is
cannot be, because of Federal Medicaid laws,
 
5)
The 'BLENDED FUNDING CARVE-OUT' is a type of managed care plan in which behavioral health funds from multiple community and government funding sources are consolidated into a single managed care pot.
 
True False
 
6)
Regarding the 'BLENDED FUNDING CARVE-OUT', please select the correct answer below, based upon information presented in this lesson.
 
In a Blended Funding Carve-Out, enrollees who move ON and OFF of the Medicaid rolls during the year may not lose their services when they are 'OFF' of Medicaid.
The plan may create havoc for a period of time, and places traditional providers at grave risk – IF they are not diversified in their funding base.
The new plan may initially dismantle or stress the 'traditional provider' delivery system and the 'safety net'.
All of the above
None of the above
 
7)
Blended Funding Carve-Out plans can produce a viable and newly configured delivery system, with expanded CHOICE for providers and consumers, and impoved systems of care across multiple agencies.
 
True False
 
8)
This lesson tells us that Blended Funding Carve-Outs can result in LESS FLEXIBILITY for behavioral health providers, and REDUCED creativity.
 
True False
 

 

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