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

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Diane

3 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...

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Von

3 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!

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Viki

2 months ago

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

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Nickolas

2 months ago

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

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Eliseo

2 months ago

Definitely, variety in reimbursement methods can help control costs.

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Marge

2 months ago

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

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Sheron

2 months ago

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

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Shawnta

2 months ago

I agree, keeping specialists on their toes is important.

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Lucina

2 months ago

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

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Reiko

3 months ago

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

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Sherell

3 months ago

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

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Gayla

3 months ago

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

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Marge

3 months ago

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

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Quentin

3 months ago

Why do you think that?

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Kirk

3 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.

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Lashanda

3 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.

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