AHM-530 Exam AI-Powered | Exam-Dumps.net (Page: 4)

QUESTION: 16

The following statement(s) can correctly be made about the TRICARE managed healthcare program of the U.S. Department of Defense.

1. Active-duty military personnel are automatically enrolled in TRICARE's HMO option (TRICARE Prime).
2. Eligible family members and dependents can enroll in TRICARE Prime, the PPO plan (TRICARE Extra), or an indemnity plan (TRICARE Standard).

Both 1 and 2
1 only
2 only
Neither 1 nor 2

Answer(s): A

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QUESTION: 17

For this question, if answer choices (A) through C) are all correct, select answer choice (D). Otherwise, select the one correct answer choice.

Understanding the level of health plan penetration in a particular market can help a health plan determine which products are most appropriate for that market. Indicators of a mature health plan market include

Areduction in the rate of growth in health plan premium levels
Areduction in the level of outcomes management and improvement
An increase in the rate of inpatient hospital utilization
All of the above

Answer(s): A

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QUESTION: 18

The Holiday Health Plan is preparing to enter a new market. In order to determine the optimal size of its provider panel in the new market, Holiday is conducting a competitive analysis of provider networks of the market's existing health plans. Consider whether, in conducting its competitive analysis, Holiday should seek answers to the following questions:

QUESTION 1: What are the cost-containment strategies of the health plans with increasing market shares? QUESTION 2: What are the premium strategies of the health plans with large market shares?
QUESTION 3: What are the characteristics of health plans that are losing market share? In its competitive analysis, Holiday should most likely obtain answers to questions

1, 2, and 3
1 and 2 only
1 and 3 only
2 and 3 only

Answer(s): A

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QUESTION: 19

The sizes of the businesses in a market affect the types of health programs that are likely to be purchased. Compared to smaller employers (those with fewer than 100 employees), larger employers (those with more than 1,000 employees) are

more likely to contract with indemnity health plans
more likely to offer their employees a choice in health plans
less likely to contract with health plans
less likely to require a wide variety of benefits

Answer(s): B

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QUESTION: 20

Provider panels can be either narrow or broad. Compared to a similarly sized health plan that uses a broad provider panel, a health plan that uses a narrow provider panel most likely can expect to

Experience higher contracting costs
Encounter increased difficulty in utilization management
Have to charge higher health plan premiums
Experience lower provider relations costs

Answer(s): D

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AHIP AHM-530 (page: 4)

QUESTION: 16

QUESTION: 17

QUESTION: 18

QUESTION: 19

QUESTION: 20