Question

multiple choice question

a(n) ________ is a managed care plan in which a network of providers supplies discounted treatment for plan members.

• ppo
• hmo
• pos
• mco

Explanation:

Analyze the question prompt

The question asks to identify a specific type of managed care plan: "A(n) ________ is a managed care plan in which a network of providers supplies discounted treatment for plan members."

Evaluate the options using mastered concepts

Using the Managed Care Plans knowledge point, let's analyze the characteristics of each option:

• PPO (Preferred Provider Organization): A plan where a network of healthcare providers agrees to provide services to plan members at discounted rates. Members can see out-of-network providers but pay less when using in-network providers.
• HMO (Health Maintenance Organization): A plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally does not cover out-of-network care except in an emergency and requires a primary care physician (PCP) referral.
• POS (Point-of-Service): A hybrid plan where members pay less if they use doctors, hospitals, and other healthcare providers that belong to the plan's network, requiring a referral from a PCP to see a specialist.
• MCO (Managed Care Organization): This is an umbrella term for organizations that provide managed care plans (like HMOs, PPOs, and POS plans), rather than a specific plan type itself.

Match definition to the correct plan

Using the Preferred Provider Organization knowledge point, we confirm that a PPO is specifically characterized by a network of "preferred" providers who contract with the insurer to offer medical services at pre-negotiated, discounted rates to the plan's members. Therefore, "PPO" is the correct term to fill in the blank.

Answer:

• (A) PPO (Correct answer)
• (B) HMO
• (C) POS
• (D) MCO