In order to achieve changes in outcomes, health plans make changes to existing structures and processes. The introduction of preauthorization as an attempt to control overuse of services is an example of a reactive change. Reactive changes are typically
Nilay Sharma suffered a small wound while working in his yard and was taken to a local hospital for treatment. A triage nurse at the hospital evaluated Mr. Sharma’s condition and directed him to an outpatient unit in the hospital where a physician assistant examined, cleaned, and sutured the wound. Mr. Sharma returned home following treatment. The care Mr. Sharma received at the hospital is an example of the type of care known as
With respect to the activities of MCO medical directors, it is correct to say that medical directors typically perform all of the following activities EXCEPT
Determine whether the following statement is true or false:
The delegation of medical management functions to providers can occur without the transfer of financial risk.
TESTED 24 Nov 2024
