Medicaid Beneficiaries Pose a Challenge for Health Plans Attempting to Establish

question 94

Multiple Choice

Medicaid beneficiaries pose a challenge for health plans attempting to establish Medicaid provider networks. Compared to membership in commercial health plans, Medicaid enrollees typically

• A) Require access to greater numbers of obstetricians and pediatricians
• B) Have stronger relationships with primary care providers
• C) Are less reliant on emergency rooms as a source of first-line care
• D) Need fewer support and ancillary services

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Definitions:

Economies of Scale

Cost advantages that entities experience as their operational size or volume increases, leading to reduced costs per unit of output.

Remuneration

The compensation a person receives in return for performing work or services, including wages, salaries, and benefits.

Non-controlling Interest

Non-controlling interest is an ownership interest in a business entity by shareholders that are not the parent company or controlling shareholders, reflecting their share of the equity in a subsidiary.

Subsidiary

A business that is under the control of another business, referred to as the parent company, by holding a majority of its voting shares.