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SH Comprehensive Practice Test
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Which description best matches a Health Maintenance Organization (HMO)?
Payer-based fee-for-service model
Prepaid group practice that integrates financing and delivery
Episode-based payment system
Per-diem hospital payments
Reveal Answer
Correct Answer:
Prepaid group practice that integrates financing and delivery
Explanation:
HMO descriptions center on prepaid care that combines how care is financed with how it’s delivered. In an HMO, members pay a fixed premium, and the organization provides and pays for most or all of their care through a single network. This prepaid structure funds a coordinated system where financing and delivery are integrated, often with a primary care physician guiding care and coordinating referrals. The aim is to emphasize preventive services and manage costs through tighter control of services and providers. This makes the description of a prepaid group practice that integrates financing and delivery the best match. The other options describe different payment approaches—fee-for-service, per-diem hospital payments, and episode-based (bundled) payments—which don’t reflect the combined financing-and-delivery setup that characterizes HMOs.
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