AHIP Exam AHM-520 Topic 2 Question 107 Discussion

Actual exam question for AHIP's AHM-520 exam

Question #: 107
Topic #: 2

The following statements are about various reimbursement arrangements that health plans have with hospitals. Select the answer choice containing the correct statement.

AA sliding scale per-diem charges arrangement differs from a sliding scale discount on charges arrangement in that only a sliding scale per-diem charges arrangement is based on total volume of admissions and outpatient procedures.

BUnder a typical reimbursement arrangement that is based on diagnosis related groups (DRGs), if the payment amount is fixed on the basis of diagnosis, then any reduction in costs resulting from a reduction in days will go to the health plan rather than to the hospital.

CA negotiated straight per-diem charge requires payment of a single charge for a day in the hospital, regardless of any actual charges or costs incurred during the hospital stay.

DA straight discount on charges arrangement is the most common reimbursement method in markets with high levels of health plans.

Show Suggested Answer

Suggested Answer: A

by Viva at Feb 11, 2025, 02:17 PM

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Cornell

27 days ago

Wait, they actually pay hospitals based on diagnoses? I thought they just threw darts at a board to determine the reimbursement rates!

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Estrella

29 days ago

Ah, the joys of health care reimbursement! I'll go with B, since it seems to align with the concept of DRGs and incentives for the hospital.

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Brittney

1 months ago

I'm going with D. In markets with high competition, health plans would likely negotiate discounted charges with hospitals to keep costs down. Sounds like the most common arrangement to me.

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Tamesha

2 days ago

I think D makes sense. It's all about negotiating costs in competitive markets.

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3 months ago

I think the correct statement is A.

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