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MC201 - Quiz 2

 

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1)
In Behavioral Health Managed Care Programs . . .
 
there are no opportunities for a provider or program to assume LIMITED RISK.
providers are almost always in a state of extreme risk.
the HMO's RISK affects the providers.
all of the above
none of the above
 
2)
The HMO's decisions about a client's treatment may contradict a provider's prevailing clinical beliefs about what is needed.
 
True False
 
3)
Based upon information presented in this lesson, it is _________________ to consider flexible programming and new treatment options.
 
never a good idea
an unacceptable legal risk
a good idea
generally a bad idea
 
4)
In order to make the money stretch for the life of the contract, the at-risk entity (typically an HMO or BHO) CONTAINS OR LIMITS ITS RISK in ways which impact . . .
 
HOW the money is spent (on what services)
WITH WHOM the money is spent (with which providers)
providers in ways that are NOT all 'bad'.
None of the above
All of the above
 
5)
In a CASE RATE provider contract, the provider _________________ than he would have in a fee-for-service agreement.
 
is given more control of treatment
is given less control of treatment
is given the same control of treatment
 
6)
ACT, which stands for _________________ is a form of 'CASE RATE' - and it is an example of 'Limited Risk Sharing'.
 
Alternative Client Training,
Augmented Consumer Treatment,
Assertive Community Treatment,
 
7)
The HMO's 'AT RISK' situation affects providers in several ways, including which of the following:
 
It impacts HOW the money is spent, and with which PROVIDERS it is spent.
It prompts the HMO to bring in new programs and treatment options which may not have been available before.
The HMO's Utilization Management decisions may contradict a provider's clinical beliefs about what is needed.
May bring about opportunities for 'LIMITED RISK SHARING' with providers, which can promote creativity and efficiency.
All of the above
 
8)
This lesson says that the State of Alabama has outlawed Provider Risk Sharing arrangements.
 
True False
 

 

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