- (Topic 1)
The Acorn Health Plan uses a resource-based relative value scale (RBRVS) to help determine the reimbursement amounts that Acorn should make to providers who are compensated under an FFS system. With regard to the advantages and disadvantages to Acorn of using RBRVS, it can correctly be stated that

1. A. An advantage of using RBRVS is that it can assist Acorn in developing reimbursement schedules for various types of providers in a comprehensive healthcare plan
2. B. An advantage of using RBRVS is that it puts providers who render more medical services than necessary at financial risk for this overutilization
3. C. A disadvantage of using RBRVS is that it will be difficult for Acorn to track treatment rates for the health plan's quality and cost management functions
4. D. A disadvantage of using RBRVS is that it rewards procedural healthcare services more than cognitive healthcare services

Correct Answer: A

- (Topic 1)
The following statements are about the new methodology authorized under the Balanced Budget Act of 1997 (BBA) for payments by the Centers for Medicaid & Medicare Services (CMS) to Medicare-contracting health plans.
Select the answer choice containing the correct statement.

1. A. Under this new methodology, Medicare-contracting health plans are paid the lower of (a) a floor payment amount per enrollee covered or (b) the health plan's payment rate increased by 2% from the previous year.
2. B. The new methodology has decreased the rate of growth in payments from CMS to Medicare-contracting health plans.
3. C. Under this new methodology, Medicare-contracting health plans are paid 90% of the adjusted average per capita cost (AAPCC) of providing a service to a beneficiary.
4. D. Under the principal inpatient diagnostic cost group (PIP-DCG), a new risk adjustment methodology, Medicare-contracting health plans will no longer be required to calculate and submit to CMS a Medicare adjusted community rate (ACR).

Correct Answer: B

- (Topic 2)
A financial analyst wants to learn the following information about the Forest health plan for a given financial period:

1. A. Forest's beginning-of-period cash balance
2. B. Forest's minimum cash balance
3. C. The cash needs of Forest during the period
4. D. Forest's end-of-period cash balanceFrom Forest's cash budget, the analyst most likely can obtain information about
5. E. A, B, C, and D
6. F. A, B, and C only
7. G. A and D only
8. H. B and C only

Correct Answer: A

- (Topic 1)
Users of the Fulcrum Health Plan financial information include:
✑ The independent auditors who review Fulcrum's financial statements
✑ Fulcrum's controller (comptroller)
✑ Fulcrum's plan members
✑ The providers that deliver healthcare services to Fulcrum plan members
✑ Fulcrum's competitors
Of these users, the ones that most likely can correctly be classified as external users with a direct financial interest in Fulcrum are the

1. A. Independent auditors, the plan members, the providers, and the
2. B. Competitors only
3. C. Independent auditors, the controller, and the providers only
4. D. Controller and the competitors only
5. E. Plan members and the providers only

Correct Answer: D

- (Topic 1)
In the following paragraph, a sentence contains two pairs of words enclosed in parentheses. Determine which word in each pair correctly completes the statement. Then select the answer choice containing the two words that you have selected.
The Igloo health plan recognizes the receipt of its premium income during the accounting
period in which the income is earned, regardless of when cash changes hands. However, Igloo recognizes its expenses when it earns the revenues related to those expenses, regardless of when it receives cash for the revenues earned. This information indicates that the (realization/capitalization) principle governs Igloo's revenue recognition, whereas the (matching/initial-recording) principle governs its expense recognition.

1. A. realization / matching
2. B. realization / initial-recording
3. C. capitalization / matching
4. D. capitalization / initial-recording

Correct Answer: A