Sean has to go to a hospital for an inpatient procedure. If he goes to St....

Sean has to go to a hospital for an inpatient procedure. If he goes to St. Bob’s Hospital he will pay a lower copayment than if he goes to St. Theresa’s Hospital. By varying the cost-sharing responsibility Sean will have to pay, the health plan is driving him to a preferred provider (in this case St. Bob’s Hospital). This is an example of?

Geo-access mapping

Hospital tiering

Hospital consolidation

All answers are correct

Which of the following regulates health insurance networks for Medicare health plans?

The Centers for Medicare and Medicaid Services (CMS)

The National Association of Insurance Commissioners (NAIC)

State departments of insurance (DOIs)

All answers are correct

Solutions

Expert Solution

1 hospital tiering

Under hospital tiering hospital and providers are ranked as per the cost of treatment they provide.

2 CMS administers or regulates the healthcare programmes for the objective of protecting health of all americans including child health insurance programme.

Hayet Jeridi answered 1 year ago

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