Practice Question
A nurse is working with a case manager for a client who participates in a health maintenance organization. The nurse should identify that a health maintenance organization provides which of the following payment structures?
Answer Choices:
Correct Answer:
The provider is paid a fixed sum for the client on a monthly or yearly basis.
Rationale:
💳 In a Health Maintenance Organization (HMO), providers are typically reimbursed through a capitation model, meaning they receive a fixed payment per member per month or year, regardless of how many services that client actually uses.
💳 This prepaid payment structure incentivizes providers to focus on preventive care and cost-efficiency, since their reimbursement is not tied to the volume of services rendered.
💳 The model allows for budget predictability and encourages coordination of care, especially through primary care providers who serve as gatekeepers to specialized services.
💳 This system contrasts sharply with fee-for-service models, where providers are paid for each individual service or procedure, often leading to increased healthcare costs and fragmented care.
Want to practice more questions like this?
This question is from RN Community Health~2019 Exam 1 which contains 58 questions.
More Questions from This Exam
A home health nurse is caring for a client who has terminal cancer and no longer wants to receive enteral tube feedings. Which of the following actions should the nurse take?
Answer Choices:
A home health nurse is discussing electrical hazards with a client. Which of the following statements should the nurse include?
Answer Choices:
A school nurse is planning primary prevention activities for the new school year. Which of the following should the nurse include? (Select all that apply.)
Answer Choices:
A nurse is working with a community health care team to devise strategies for preventing violence in the community. Which of the following interventions is an example of tertiary prevention?
Answer Choices:
A faith-based organization asks a community health nurse to develop a mobile meal program for older adults who are no longer driving. Which of the following actions should the nurse plan to take first?
Answer Choices:
Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI Community Health
- Answer Choices: 4