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AHIP AHM-520 Health Plan Finance and Risk Management Exam Practice Test

Demo: 32 questions
Total 215 questions

Health Plan Finance and Risk Management Questions and Answers

Question 1

For each of its products, the Wisteria Health Plan monitors the provider reimbursement trend and the residual trend. One true statement about these trends is that

Options:

A.

The provider reimbursement trend probably is more difficult for Wisteria to quantify than is the residual trend

B.

Wisteria's residual trend is the difference between the total trend and the portion of the total trend caused by changes in Wisteria's provider reimbursement levels

C.

The residual trend most likely has more impact on Wisteria's total trend than does the provider reimbursement trend

D.

An example of a residual trend would be a 5% increase in the capitation rate paid to a PCP by Wisteria

Question 2

Provider reimbursement methods that transfer some utilization risk from a health plan to providers affect the health plan's RBC formula. A health plan's use of these reimbursement methods is likely to result in

Options:

A.

An increase the health plan's underwriting risk

B.

A decrease the health plan's credit risk

C.

A decrease the health plan's net worth requirement

D.

All of the above

Question 3

This concept, which is an extension of the going-concern concept, holds that the value of an asset that a company reports in its accounting records should be the asset's historical cost, not its current market value. Although this concept offers objectivity and reliability, it may lack relevance, particularly for assets held for a long period of time.

From the following answer choices, choose the name of the accounting concept that matches the description.

Options:

A.

Measuring-unit concept

B.

Full-disclosure concept

C.

Cost concept

D.

Time-period concept

Question 4

The following statements illustrate common forms of capitation:

1. The Antler Health Plan pays the Epsilon Group, an integrated delivery system (IDS), a capitated amount to provide substantially all of the inpatient and outpatient services that Antler offers. Under this arrangement, Epsilon accepts much of the risk that utilization rates will be higher than expected. Antler retains responsibility for the plan's marketing, enrollment, premium billing, actuarial, underwriting, and member services functions.

2. The Bengal Health Plan pays an independent physician association (IPA) a capitated amount to provide both primary and specialty care to Bengal's plan members. The payments cover all physician services and associated diagnostic tests and laboratory work. The physicians in the IPA determine as a group how the individual physicians will be paid for their services.

From the following answer choices, select the response that best indicates the form of capitation used by Antler and Bengal.

Options:

A.

Antler = subcapitation

Bengal = full-risk capitation

B.

Antler = subcapitation

Bengal = full professional capitation

C.

Antler = global capitation

Bengal = subcapitation

D.

Antler = global capitation

Bengal = full professional capitation

Question 5

The Eclipse Health Plan is a not-for-profit health plan that qualifies under the Internal Revenue Code for tax-exempt status. This information indicates that Eclipse

Options:

A.

Has only one potential source of funding: borrowing money

B.

Does not pay federal, state, or local taxes on its earnings

C.

Must distribute its earnings to its owners-investors for their personal gain

D.

Is a privately held corporation

Question 6

Under the alternative funding method used by the Flair Company, Flair assumes financial responsibility for paying claims up to a specified level and deposits the funds necessary to pay these claims into a bank account that belongs to Flair. However, an insurer, which acts as an agent of Flair, makes the actual payment of claims from this account. When claims exceed the specified level, the insurer pays the balance from its own funds. No state premium tax is levied on the amounts that Flair deposits into this bank account.

From the following answer choices, choose the name of the alternative funding method described.

Options:

A.

Retrospective-rating arrangement

B.

Premium-delay arrangement

C.

Reserve-reduction arrangement

D.

Minimum-premium plan

Question 7

The Caribou health plan is a for-profit organization. The financial statements that Caribou prepares include balance sheets, income statements, and cash flow statements. To prepare its cash flow statement, Caribou begins with the net income figure as reported on its income statement and then reconciles this amount to operating cash flows through a series of adjustments. Changes in Caribou's cash flow occur as a result of the health plan's operating activities, investing activities, and financing activities.

The main purpose of Caribou's balance sheet is to

Options:

A.

Reveal how Caribou obtained particular assets or liabilities

B.

Show how much money Caribou has realized from its operations during an accounting period

C.

Measure the owners' wealth

D.

Reconcile the cash that Caribou has on hand at the beginning and at the end of an accounting period

Question 8

The NAIC has developed a risk-based capital (RBC) formula for all health plans that accept risk. One true statement about the RBC formula for health plans is that it

Options:

A.

is a set of calculations, based on information in a health plan's annual financial report, that yields a target capital requirement for the organization

B.

fails to take into account a health plan's underwriting risk, which is the risk that the premiums the health plan receives will be insufficient to pay for the healthcare services it provides to its plan members

C.

applies to all health plans in the United States

D.

fails to assess the specific level of risk faced by each health plan

Question 9

The following statements are about a health plan's underwriting of small groups. Select the answer choice containing the correct statement.

Options:

A.

Almost all states prohibit health plan s from rejecting a small group because of the nature of the business in which the small business is engaged.

B.

Most states prohibit health plans from setting participation levels as a requirement for coverage, even when coverage is otherwise guaranteed issue.

C.

In underwriting small groups, a health plan's underwriters typically consider both the characteristics of the group members and of the employer.

D.

Generally, a health plan's underwriters require small employers to contribute at least 80% of the cost of the healthcare coverage.

Question 10

The physicians who work for the Sunrise Health Plan, a staff model HMO, are paid a salary that is not augmented with another type of incentive plan. Compared to the use of a traditional reimbursement method, Sunrise's use of a salary reimbursement method is more likely to

Options:

A.

Encourage Sunrise's physicians to perform services that are not medically necessary

B.

Completely eliminate service risk for Sunrise's physicians

C.

Decrease Sunrise's liability for any negligent acts of the physicians in the plan's network of providers

D.

Help stabilize expenses for Sunrise

Question 11

The Caribou health plan is a for-profit organization. The financial statements that Caribou prepares include balance sheets, income statements, and cash flow statements. To prepare its cash flow statement, Caribou begins with the net income figure as reported on its income statement and then reconciles this amount to operating cash flows through a series of adjustments. Changes in Caribou's cash flow occur as a result of the health plan's operating activities, investing activities, and financing activities.

To prepare its cash flow statement, Caribou uses the direct method rather than the indirect method.

Options:

A.

True

B.

False

Question 12

Rasheed Azari, the risk manager for the Tower health plan, is attempting to work with providers in the organization in order to reduce the providers' exposure related to utilization review. Mr. Azari is considering advising the providers to take the following actions:

  • 1-Allow Tower's utilization management decisions to override a physician's independent medical judgment
  • 2-Support the development of a system that can quickly render a second opinion in case of disagreement surrounding clinical judgment
  • 3-Inform a patient of any issues that are being disputed relative to a physician's recommended treatment plan and Tower's coverage decision

Of these possible actions, the ones that are likely to reduce physicians' exposures related to utilization review include actions

Options:

A.

1, 2, and 3

B.

1 and 2 only

C.

1 and 3 only

D.

2 and 3 only

Question 13

The following statements are about carve-out programs. Three of these statements are true, and one statement is false. Select the answer choice containing the FALSE statement.

Options:

A.

In the type of carve-out in which entire categories of care are administered by independent organizations, a health plan typically reimburses these organizations under an FFS contract.

B.

Typically, a health plan will offer carved-out services to its enrollees, but will manage these services separately.

C.

Carve-outs are services that are excluded from a capitation payment, a risk pool, or a health benefit plan.

D.

The most rapidly growing area related to carve-outs is disease management (DM).

Question 14

The Atoll Health Plan must comply with a number of laws that directly affect the plan's contracts. One of these laws allows Atoll's plan members to receive medical services from certain specialists without first being referred to those specialists by a primary care provider (PCP). This law, which reduces the PCP's ability to manage utilization of these specialists, is known as _________.

Options:

A.

A due process law

B.

An any willing provider law

C.

A direct access law

D.

A fair procedure law

Question 15

The following paragraph contains an incomplete statement. Select the answer choice containing the term that correctly completes the statement. Health plans face four contingency risks (C-risks): asset risk (C-1), pricing risk (C-2), interest-rate risk (C-3), and general management risk (C-4). Of these risks, ________________ is typically the most important risk that health plans face. This is true because a sizable portion of the total expenses and liabilities faced by a health plan come from contractual obligations to pay for future medical costs, and the exact amount of these costs is not known when the healthcare coverage is priced.

Options:

A.

Asset risk (C-1)

B.

Pricing risk (C-2)

C.

Interest-rate risk (C-3)

D.

General management risk (C-4)

Question 16

Experience rating methods can be either prospective or retrospective. With regard to these types of experience rating methods, it can correctly be stated that

Options:

A.

A health plan typically can expect much higher profit levels from using retrospective experience rating rather than prospective experience rating a health plan using prospective experience rating is more likely than a

B.

Health plan using retrospective experience rating to have to pay an experience rating dividend if a group's experience has been better than expected during the rating period

C.

The premium determined under retrospective experience rating is usually higher than the premium under prospective experience rating

D.

Most states require HMOs to use retrospective experience rating rather than prospective experience rating

Question 17

The Norton Health Plan used blended rating to develop a premium rate for the Roswell Company, a large employer group. Norton assigned Roswell a credibility factor of 0.7 (or 70%). Norton calculated Roswell’s manual rate to be $200 and its experience claims cost as $180. Norton’s retention charge is $3. This information indicates that Roswell’s blended rate is:

Options:

A.

$186

B.

$189

C.

$194

D.

$197

Question 18

If the total asset turnover ratio for the Fjord health plan is 1.08 and the total asset turnover ratio for the Grove health plan is 1.35, then a financial analyst could correctly infer that Fjord has used its assets more effectively than has Grove.

Options:

A.

True

B.

False

Question 19

Residual trend is the difference between total trend and the portion of the total trend caused by changes in provider reimbursement levels.

Consider the following events that could affect an health plan’s provider reimbursement levels:

Event 1 — The disenrollment of a large group with unusually high utilization rates

Event 2 — The introduction of a new treatment for infertility

Event 3 — A serious flu epidemic

Event 4 — A shift in inpatient medical services from obstetrical care to neonatal intensive care

One cause of residual trend is change in intensity, which would be represented by:

Options:

A.

Event 1

B.

Event 2

C.

Event 3

D.

Event 4

Question 20

The following paragraph contains two pair of terms enclosed in parentheses. Determine which term in each pair correctly completes the statements. Then select the answer choice containing the two terms you have chosen.

In a typical health plan, an (actuary / underwriter) is ultimately responsible for the determination of the appropriate rate to charge for a given level of healthcare benefits and administrative services in a particular market. The (actuary / underwriter) assesses and classifies the degree of risk represented by a proposed group or individual.

Options:

A.

actuary / actuary

B.

actuary / underwriter

C.

underwriter / actuary

D.

underwriter / underwriter

Question 21

The risk-based capital formula for health plans defines a number of risks that can impact a health plan’s solvency. These categories reflect the fact that the level of risk faced by health plans is significantly impacted by provider reimbursement methods that shift utilization risk to providers. The following statements are about the effect of a health plan transferring utilization risk to providers. Select the answer choice containing the correct statement:

Options:

A.

The net effect of using provider reimbursement contracts to transfer risk is that the health plan’s net worth requirement increases.

B.

Once the health plan has transferred utilization risk to its providers, it is relieved of the legal obligation to provide medical services to plan members in the event of the provider’s insolvency.

C.

The greater the amount of risk the health plan transfers to providers, the larger the credit-risk factor becomes in the health plan’s RBC formula.

D.

By decreasing its utilization risk, the health plan increases its underwriting risk.

Question 22

The Rathbone Company has contracted with the Jarvin Insurance Company to provide healthcare benefits to its employees. Under this contract, Rathbone assumes financial responsibility for paying 80% of its estimated annual claims and for depositing the funds necessary to pay these claims into a bank account. Although Rathbone owns the bank account, Jarvin, acting as Rathbone’s agent, makes the actual claims payments from this account. Claims in excess of Rathbone’s contracted percentage are paid by Jarvin. Rathbone pays to Jarvin a premium for administering the entire plan and bearing the costs of claims in excess of Rathbone’s obligation. This premium is substantially lower than would be charged if Jarvin were providing healthcare coverage under a traditional fully insured group plan. Jarvin is required to pay premium taxes only on the premiums it receives from Rathbone. This information indicates that the type of alternative funding method used by Rathbone is known as a:

Options:

A.

Premium-delay arrangement

B.

Reserve-reduction arrangement

C.

Minimum-premium plan

D.

Retrospective-rating arrangement

Question 23

The medical loss ratio (MLR) for the Peacock health plan is 80%. Peacock's expense ratio is 16%.

One characteristic of Peacock's MLR is that it

Options:

A.

Includes claims that have been paid but excludes claims that have not yet been reported

B.

Cannot adjust for growth in the health plan's business

C.

Is the percentage of Peacock's end-of-period surplus to its earned premiums

D.

Measures Peacock's overall claims levels

Question 24

In order to show the efficiency of a health plan's managers in using the health plan's investments to earn a return for stockholders, a financial analyst most likely would use a type of profitability ratio known as

Options:

A.

A net gain-to-total income ratio

B.

An insurance leverage ratio

C.

A statutory return on assets (ROA) ratio

D.

A gross profit ratio

Question 25

The goals of Diane Tsai, the manager of the Oval Health Plan's accounting department, and the goals of Oval are mutually supportive. Oval's accounting department is able to establish and achieve the appropriate objectives, but the department's costs of operation are too high. The following statement(s) can correctly be made about this situation:

Options:

A.

Ms. Tsai most likely is the manager of a profit center.

B.

The business goals of Oval are congruent with Ms. Tsai's goals.

C.

Oval's accounting department is efficient but not effective.

D.

All of these statements are correct.

Question 26

In order to achieve its goal of improved customer service, the Evergreen Health Plan will add three new customer service representatives to its existing staff, install a new switching station, and install additional phone lines. In this situation, the cost that would be classified as a sunk cost, rather than a differential cost, is the expense associated with:

Options:

A.

Adding new customer service representatives

B.

Maintaining the existing staff

C.

Installing a new switching station

D.

Installing additional phone lines

Question 27

One true statement about variance analysis is that

Options:

A.

A price variance is the difference between the budgeted quantities to be sold and the actual quantities sold, multiplied by the budgeted amount

B.

Variance analysis suggests solutions to a particular problem

C.

Positive variances generally are favorable, from a health plan's point of view, for the plan's expenses but unfavorable for the plan's revenues

D.

An effective variance system typically focuses on matters that require management's attention

Question 28

The following transactions occurred at the Lane Health Plan:

  • Transaction 1 — Lane recorded a $25,000 premium prior to receiving the payment
  • Transaction 2 — Lane purchased $500 in office expenses on account, but did not record the expense until it received the bill a month later
  • Transaction 3 — Fire destroyed one of Lane’s facilities; Lane waited until the facility was rebuilt before assessing and recording the amount of loss
  • Transaction 4 — Lane sold an investment on which it realized a $14,000 gain; Lane recorded the gain only after the sale was completed.

Of these transactions, the one that is consistent with the accounting principle of conservatism is:

Options:

A.

Transaction 1

B.

Transaction 2

C.

Transaction 3

D.

Transaction 4

Question 29

The Arista Health Plan is evaluating the following four groups that have applied for group healthcare coverage:

  • The Blaise Company, a large private employer
  • The Colton County Department of Human Services (DHS)
  • A multiple-employer group comprised of four companies
  • The Professional Society of Daycare Providers

With respect to the relative degree of risk to Arista represented by these four companies, the company that would most likely expose Arista to the lowest risk is the:

Options:

A.

Blaise Company

B.

Colton County DHS

C.

Multiple-employer group

D.

Professional Society of Daycare Providers

Question 30

The Coral Health Plan, a for-profit health plan, has two sources of capital:

Debt and equity. With regard to these sources of capital, it can correctly be stated that

Options:

A.

Coral's equity holders have an ownership interest in the health plan

B.

The interest that Coral pays on its debt most likely is not tax deductible to Coral

C.

Coral's debt holders have no legal claim to Coral's assets

D.

Equity is a more risky source of capital, from Coral's perspective, than is debt

Question 31

The following information was presented on one of the financial statements prepared by the Rouge health plan as of December 31, 1998:

When calculating its cash-to-claims payable ratio, Rouge would correctly divide its:

Options:

A.

Cash by its reported claims only

B.

Cash by its reported claims and its incurred but not reported claims (IBNR)

C.

Reported claims by its cash

D.

Reported claims and its incurred but not reported claims (IBNR) by its cash

Question 32

The Amethyst Health Plan uses a budgeting approach that requires each line of business within Amethyst’s operation to justify its continued operation. Amethyst begins with the premise that no resources will be allocated for the following period unless each dollar to be spent is justified and is shown to be within departmental plans and corporate goals and objectives. The budgeting approach used by Amethyst is known as:

Options:

A.

Bottom-up budgeting

B.

Top-down budgeting

C.

Zero-based budgeting

D.

Master budgeting

Demo: 32 questions
Total 215 questions