Practice Question
A nurse is working with a care 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:
📅 A Health Maintenance Organization (HMO) operates on a capitation payment model, where healthcare providers receive a fixed amount per client regardless of how many services the client uses.
📅 This structure encourages providers to focus on preventive care and cost-effective treatment, since their reimbursement does not increase with additional procedures.
📅 The goal of an HMO is to promote coordinated, comprehensive, and preventive care while controlling healthcare costs.
📅 This contrasts with fee-for-service models, which reimburse providers based on each specific service rendered.
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This question is from RN Community Health~2023 Exam 4 which contains 57 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI Community Health
- Answer Choices: 4