What three factors are critical in differentiating between the types of managed care organization (MCOs)?
CEO with responsibility for operations
Payment and risk-sharing
Organized physician staff
Choice of providers
Different ways of arranging services
Correct Answer : B,D,E
Rationale:
A. CEO with responsibility for operations: While the leadership structure may vary among different managed care organizations (MCOs), it is not one of the critical factors in differentiating between types of MCOs.
B. Payment and risk-sharing: Payment mechanisms and risk-sharing arrangements are crucial factors that differentiate between different types of MCOs, such as HMOs, PPOs, and POS plans.
C. Organized physician staff: While the organization of physician staff may vary among MCOs, it is not one of the critical factors in differentiating between types of MCOs.
D. Choice of providers: The availability of provider networks and the degree of member choice in selecting healthcare providers are important factors that differentiate between types of MCOs.
E. Different ways of arranging services: The methods by which healthcare services are arranged and delivered, such as through primary care gatekeepers or direct access to specialists, are critical factors that distinguish between different types of MCOs.
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Related Questions
Correct Answer is D
Explanation
Rationale:
A. Training in community health, public health, and geriatrics: While important for addressing workforce challenges, this option focuses on specific areas of training rather than broader workforce strategies.
B. Unify licensing and scope of practice across states: This proposal aims to address regulatory barriers but may not directly address workforce challenges as comprehensively as other options.
C. Nurses should practice to the full extent of their training and education: This proposal focuses on maximizing the role of nurses, which is important but may not address all aspects of future workforce challenges.
D. Flexibility, cross-training, and skills in nonclinical areas (such as supervision): This proposal emphasizes adaptability and diversification of skills, which can help address workforce
challenges by enabling healthcare professionals to fill multiple roles and adapt to changing healthcare needs.
Correct Answer is C
Explanation
Rationale:
A. 90%: This percentage is higher than the actual proportion of hospitals that are private nonprofit hospitals.
B. 100%: This option suggests that all hospitals are private nonprofit hospitals, which is not accurate.
C. 75%: According to Shi and Singh, approximately 75% of hospitals in the United States were private nonprofit hospitals in 2019.
D. 48%: This percentage is lower than the actual proportion of hospitals that are private nonprofit hospitals.
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