Asked by Scott Wilson on May 02, 2024
Verified
Which statement is true regarding health maintenance organizations?
A) They focus on medical procedures and services rather than on wellness and preventive care.
B) They require subscribers to complete paperwork and file claims for routine procedures.
C) Physicians with HMO contracts are often paid a capitated rate.
D) Routine annual physical examinations are discouraged.
E) Patients generally do not have to make copayments.
Health Maintenance Organizations
A type of health insurance plan that typically requires members to receive care from a network of specified healthcare providers and facilities to be covered.
Capitated Rate
A payment arrangement for healthcare service providers where they receive a set amount for each enrolled person assigned to them, regardless of the amount of services provided.
Copayments
A fixed amount paid by a patient for a covered healthcare service, usually when receiving the service, with the rest covered by their insurance.
- Explain the role and payment structures of health maintenance organizations (HMOs).
Verified Answer
Learning Objectives
- Explain the role and payment structures of health maintenance organizations (HMOs).
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