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Question: 1

By definition, the development and implementation of parameters for the delivery of healthcare services to a health plan’s members is known as

  1. utilization management (UM)
  2. quality management (QM)
  3. care management
  4. clinical practice management


Answer: D

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Question: 1

By definition, the development and implementation of parameters for the delivery of healthcare services to a health plan’s members is known as

  1. utilization management (UM)
  2. quality management (QM)
  3. care management
  4. clinical practice management


Answer: D

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Question: 4

The paragraph below contains two pairs of terms enclosed in parentheses. Select the term in each pair that correctly completes the paragraph. Then select the answer choice containing the two terms that you have chosen.

Under a delegation arrangement, the (delegate / delegator) is responsible for performing the delegated function according to established standards, and the (delegate / delegator) is ultimately accountable for any deficiencies in the performance of the function.

  1. delegate / delegate
  2. delegate / delegator
  3. delegator / delegate
  4. delegator / delegator


Answer: B

Question: 2

Determine whether the following statement is true or false:

With respect to the size of a managed care organization (MCO) and its medical management operations, it is correct to say that large health plans typically have more integration among activities and less specialization of roles than do small MCOs.

  1. True
  2. False


Answer: B