AHIP Exam AHM-530 Topic 3 Question 100 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 100
Topic #: 3

The following statement(s) can correctly be made about contracting and reimbursement of specialty care physicians (SCPs):

ATypically, a health plan should attempt to control utilization of SCPs before attempting to place these providers under a capitation arrangement.

BForms of specialty physician reimbursement used by health plans include a retainer and a bundled case rate.

CBoth A and B

DA only

EB only

FNeither A nor B

Show Suggested Answer

Suggested Answer: A

by Gladys at Sep 19, 2024, 01:56 AM

Limited Time Offer

25%

Off

Get Premium AHM-530 Questions as Interactive Web-Based Practice Test or PDF

Contribute your Thoughts:

Submit Cancel

Diane

1 months ago

C is the correct answer for sure. Although, I heard a rumor that the health plan execs enjoy a good game of 'Specialty Physician Twister' to keep things interesting. Not that I'd know anything about that...

upvoted 0 times

...

Von

1 months ago

Option C is the way to go. Wouldn't want those specialists to get too comfortable, now would we? Gotta keep 'em guessing!

upvoted 0 times

Viki

13 days ago

It's important to have a variety of strategies in place to manage specialty care physicians.

upvoted 0 times

...

Nickolas

15 days ago

It's all about finding the right balance in managing specialty care physicians.

upvoted 0 times

...

Eliseo

16 days ago

Definitely, variety in reimbursement methods can help control costs.

upvoted 0 times

...

Marge

21 days ago

Definitely, can't let them get too comfortable with just one method of payment.

upvoted 0 times

...

Sheron

23 days ago

Yeah, we need to control utilization and use different forms of reimbursement to keep them on their toes.

upvoted 0 times

...

Shawnta

24 days ago

I agree, keeping specialists on their toes is important.

upvoted 0 times

...

Lucina

30 days ago

I agree, option C seems like the best approach to keep SCPs in check.

upvoted 0 times

...

Reiko

2 months ago

I'm going with Option C as well. Gotta keep those specialist docs on a tight leash, am I right? *wink wink*

upvoted 0 times

Sherell

1 months ago

It's all about finding the right balance between quality care and cost control.

upvoted 0 times

...

Gayla

1 months ago

I agree, having different reimbursement options gives more flexibility in managing costs.

upvoted 0 times

...

Marge

1 months ago

Definitely, controlling utilization is key. Can't let those costs get out of hand.

upvoted 0 times

...

Quentin

2 months ago

Why do you think that?

upvoted 0 times

...

Kirk

2 months ago

I agree with Lashanda. This question is testing our understanding of how health plans can effectively manage specialty care physician reimbursement and utilization.

upvoted 0 times

...

Lashanda

2 months ago

Option C seems to be the correct answer. Both controlling utilization and using different reimbursement forms like retainer and bundled case rate are important for managing specialty care providers.

upvoted 0 times