PAHM Practice Questions - AHIP Professional, Academy for Healthcare Management (PAHM) Exam - PAHM Practice Questions - AHIP Professional, Academy for Healthcare Management (PAHM) Exam

Question 1

Which feature is most characteristic of a traditional Health Maintenance Organization (HMO)?

Members select a primary care physician (PCP) who coordinates referrals to specialists Members are reimbursed on a pure fee-for-service basis with no network Out-of-network services are always covered at the same cost as in-network Members pay no premium because the federal government funds the plan

Correct Answer:

Members select a primary care physician (PCP) who coordinates referrals to specialists

Question 2

In a staff-model HMO, how are primary care physicians typically paid?

Salary as employees of the HMO Per-member-per-month capitation paid to an independent group Fee-for-service at billed charges Bundled DRG payments for inpatient stays

Correct Answer:

Salary as employees of the HMO

Question 3

Which HMO model contracts with multiple independent multispecialty groups to provide care?

Network model Staff model Group model Indemnity model

Correct Answer:

Network model

Question 4

An Independent Practice Association (IPA) HMO contracts with:

Independent physicians who practice in their own offices A single multispecialty group practice exclusively Physicians who are employees of the HMO Only hospital-based physicians

Correct Answer:

Independent physicians who practice in their own offices

Question 5

How does a Preferred Provider Organization (PPO) primarily differ from an HMO?

A PPO covers out-of-network care at reduced benefits and does not require a PCP referral A PPO uses capitation, while an HMO uses fee-for-service A PPO requires members to choose a PCP gatekeeper A PPO is only available through Medicare Advantage

Correct Answer:

A PPO covers out-of-network care at reduced benefits and does not require a PCP referral

Question 1

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About this Exam

Prepare with the PAHM Practice Questions - AHIP Professional, Academy for Healthcare Management (PAHM) Exam practice quiz. This question bank includes 100 questions covering health, medicare, plan, care, and typically. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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PAHM Practice Questions - AHIP Professional, Academy for Healthcare Management (PAHM) Exam

This practice set contains 100 questions from the matching question bank and focuses on health, medicare, plan, care, and typically. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

This is an independent study resource intended for practice and review; it is not an official examination or an endorsement by any organization named in the title.

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PAHM Practice Questions - AHIP Professional, Academy for Healthcare Management (PAHM) Exam

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