The Following Statements Are About the Financial Risks for Health

question 119

Multiple Choice

The following statements are about the financial risks for health plans in Medicare and Medicaid markets. Three of these statements are true, and one statement is false. Select the answer choice containing the FALSE statement.

• A) One reason that health plans in the Medicare and Medicaid markets experience financial risk is that government regulations determine which services must be provided to Medicare and Medicaid enrollees.
• B) Effective use of hospital utilization is the single most likely factor to contribute to the success of a Medicare-contracting health plan.
• C) If a Medicare-contracting health plan is a provider-sponsored organization (PSO), it is prohibited from sharing financial risk with its providers.
• D) Typically, providers are more reluctant to accept financial risk in connection with providing services to the Medicaid population than with providing services to the Medicare population.

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Definitions:

Evidence

Information presented in legal proceedings such as documents, witness testimony, or physical objects, used to establish facts and influence the decision of the court.

Preliminary Injunction

A court order issued early in a lawsuit that prohibits the parties from taking a specific action until a final decision is made.

Notice And Comment

A process within administrative law where the public is given the opportunity to participate in the drafting of regulations by submitting observations and feedback.

Public Housing Authorities

Governmental organizations tasked with providing affordable housing options to low-income individuals and families through the management and development of public housing.