A client has recently changed health insurance plans and is now part of a health maintenance organization (HMO). How might the nurse best explain how HMOs operate?
a. HMOs provide creative ways to ensure hospitals can decrease their daily census.
b. HMOs employ a group of nurses who focus on health education programs.
c. HMOs encourage physicians to focus on health promotion and self-care.
d. HMOs organize a network of providers who offer services for a predetermined fee.
Question 2
Which of the following is considered to be a responsibility of an insurance company?
a. Establishing guidelines for employees in hospitals
b. Establishing the rules of medical practice
c. Managing third-party reimbursement
d. Purchasing and managing hospitals and extended care facilities
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