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AHIP Certification AHM-520 Release Date

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Question 24

The following statements are about the option for health plan funding known as a self-funded plan. Select the answer choice containing the correct response:

Options:

A.

In a self-funded plan, an employer is relieved of all risk associated with paying for the healthcare costs of its employees.

B.

Self-funded plans are subject to the same state laws and regulations that apply to health insurance policies.

C.

Employers electing to self-fund a health plan are required to pay claims from a separate trust established for that purpose.

D.

An employer electing to self-fund a health plan has the option of purchasing stop-loss insurance to transfer part of the financial risk to an insurer.

Question 25

Many clinicians are concerned about the development of practice guidelines that seek to define appropriate healthcare services that should be provided to a patient who has been diagnosed with a specific condition. To avoid the risk associated with using such guidelines, health plans should advise clinicians that the existence of such a guideline:

1. Establishes standards of care to be routinely utilized with all patients presenting a specific condition

2. Preempts a physician’s judgment when assessing the specific factors related to a patient’s condition

Options:

A.

Both 1 and 2

B.

1 only

C.

2 only

D.

Neither 1 nor 2

Question 26

In order to print all of its forms in-house, the Prism health plan is considering the purchase of 10 new printers at a total cost of $30,000. Prism estimates that the proposed printers have a useful life of 5 years. Under its current system, Prism spends $10,000 a year to have forms printed by a local printing company. Assume that Prism selects a 15% discount rate based on its weighted-average costs of capital. The cash inflows for each year, discounted to their present value, are shown in the following chart:

Prism will use both the payback method and the discounted payback method to analyze the worthiness of this potential capital investment. Prism's decision rule is to accept all proposed capital projects that have payback periods of four years or less.

Now assume that Prism decides to use the net present value (NPV) method to evaluate this potential investment's worthiness and that Prism will accept the project if the project's NPV is greater than $4,000. Using the NPV method, Prism would correctly conclude that this project should be

Options:

A.

Rejected because its NPV is $3,520

B.

Accepted because its NPV is $5,028

C.

Accepted because its NPV is $16,480

D.

Accepted because its NPV is $23,520

Question 27

The core of a health plan's strategic financial plan is the development of its pro forma financial statements. The following statements are about these pro forma financial statements. Select the answer choice containing the correct statement.

Options:

A.

A health plan's pro forma financial statements forecast what the plan's financial condition will be at the end of an accounting period, without regard to whether the health plan achieves its objectives.

B.

Forecasting the balance sheet is more critical to the health plan than forecasting either the cash flow statement or the income statement, because the balance sheet drives the development of the other two statements.

C.

In order to avoid allowing the desired financial results to drive the assumptions used in developing the pro forma income statement, a health plan should avoid linking these assumptions to the health plan's overall strategic plan.

D.

A health plan can use its pro forma cash flow statement to calculate the net present value of the health plan's strategic plan.

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Exam Code: AHM-520
Exam Name: Health Plan Finance and Risk Management
Last Update: Dec 22, 2024
Questions: 215
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