AHIP Exam AHM-530 Topic 2 Question 108 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 108
Topic #: 2

The Bruin Health Plan is a Social Health Maintenance Organization (SHMO). As an SHMO, Bruin:

AMust provide Medicare participants with standard HMO benefits, as well as with limited long-term care benefits

BDoes not need as great a variety of provider types or as complex a reimbursement method as does a traditional HMO

CReceives a payment that is based on reasonable costs and reasonable charges

DMost likely provides fewer supportive services than does a traditional HMO, because one of Bruin's goals is to minimize the use of community-based care

Show Suggested Answer

Suggested Answer: A

by Mammie at Mar 09, 2025, 12:34 AM

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Hildegarde

6 days ago

I was leaning towards C, but I think A is the better choice here. The payment method is not the defining feature of an SHMO.

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Sharen

10 days ago

The correct answer is A. SHMOs must provide Medicare participants with standard HMO benefits, as well as with limited long-term care benefits. This is a key characteristic of these organizations.

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