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A managed care contract coordinated care plan that has a network of providers that have agreed to a contractually specified reimbursement for covered benefits with the organization offering the plan

A. Exclusive Provider Organization (EPO)
B. Preferred Provider Organization (PPO)
C. Health Maintenance Organization (HMO)
D. Accountable Care Organization (ACO)

1 Answer

6 votes

Final answer:

An HMO is the managed care plan that involves a network of providers who agree on pre-negotiated rates, which matches the description provided by the student. In the context of the question, the appropriate answer would be C. Health Maintenance Organization (HMO), since it is a type of managed healthcare system that offers a network of healthcare providers who agree on pre-arranged prices for services.

Step-by-step explanation:

The student has described a scenario involving a managed care contract where a network of providers agrees on a reimbursement for covered benefits with an organization offering the plan. The options provided relate to different types of healthcare plans which can include: an Exclusive Provider Organization (EPO), a Preferred Provider Organization (PPO), a Health Maintenance Organization (HMO), and an Accountable Care Organization (ACO). An EPO is a managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan's network (except in an emergency).

A PPO is a type of health plan where patients pay less if they use providers in the plan's network, and they can use doctors, hospitals, and providers outside of the network for an additional cost. An HMO offers a wide range of healthcare services through a network of providers who agree to supply services to members. Lastly, an ACO is a group of doctors, hospitals, and other healthcare providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients.

In the context of the question, the appropriate answer would be C. Health Maintenance Organization (HMO), since it is a type of managed healthcare system that offers a network of healthcare providers who agree on pre-arranged prices for services.

answered
User Olivier Amblet
by
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