The health plan activities include the following: (a) Utilization Review, (b) Claims Administration, (c) Marketing, (d) Underwriting,(e) All the above, (f) All except “d” (2) T/F.Health Maintenance organizations include staff model, group model, individual practice association model and network model. (3) T/F. An integrated delivery system is a strategic alliance among doctors, hospitals and other ancillary providers to deliver care to a defined population. (4) T/F. Capitation payment is a payment usually per member per month (PMPM) , with the covered benefits being defined. (5) With the Affordable Care Act (ACA), the goal is to achieve the three part aim: (a) improve the experience of the community, improve the health of the individuals and increasing per capita costs. (b) improving the experience of minorities, improving the health of minorities and increasing per capita costs. (c)improving the experience of individuals, improving the health of populations and lowering per capita costs, (d) improving the experience of individuals, improving the health of populations and increasing per capita costs. (6) T/F. An accountable Care Organization (ACO) is a set of healthcare providers, including primary care physicians, specialists, and hospitals, that work together collaboratively and accept collective accountability for the costs and quality of care delivered to a population of patients. (7) T/F. It is felt for an ACO to be successful: it must be led by a hospital of health care system. (8) T/F Centers for Medicare and Medicaid are currently testing several models of care delivery re-design that aim to improve the efficiency of American healthcare systems. These include: Advance payment incentive, pioneer ACO demonstration and Medicare shared savings ACO program. (9) Identify the primary characteristics of an ACO. (A) Incentive cost control by providers, (b) formed around a strong primary care, specialty and hospital physician-led alliance, (c) formed in order to serve all patients equally, not just the people covered by Medicare, ((d) Use of medical technology to manage patients across the continuum, (e) clear organizational mission and commitment to achieve quality and cost efficiencies, (f) All the above (g) All except “c” (10) T/F. It has been determined that the accountable care organizations are going to provide real cost savings and will help to decrease the nation’s health care spending and dept. Logon rmu.edu/blackboard, username: jabst156, pw: Comsaf2003. select HSAM1500 for week 6&7 chapters of Essential of Healthcare Finance. Seventh Edition. Author: Willian O Cleverley, Paula H. Song, and James O Cleverley for readings and resources