QUESTION IMAGE
Question
instructions: select the most appropriate response
which of these was implemented to create flexibility in managed care plans, which would allow patients to self-refer to out-of-network
providers?
a. competitive medical plan (cmp)
b. customized sub-capitation plan (cscp)
c. preferred provider organization (ppo)
d. point-of-service plan (pos)
Point - of - service (POS) plans offer flexibility. In a POS plan, patients can choose to see in - network providers (with lower out - of - pocket costs) or out - of - network providers (with higher costs but more choice). This self - referral ability to out - of - network providers is a key feature that provides flexibility.
Competitive medical plans (CMPs) are more about cost - competition among providers. Customized sub - capitation plans (CSCPs) focus on a specific payment mechanism (sub - capitation). Preferred provider organizations (PPOs) have a network of preferred providers, but usually require a referral (in some cases) to see out - of - network providers (not as flexible as POS in terms of self - referral).
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d. Point - of - service plan (POS)