The major form(s) of managed care organizations are:

Question

Options

• AFee-for-service with utilization review
• BPreferred provide organizations (PPOs)
• CHealth maintenance organizations (HMOs)
• DAll of the above.

• A
  6% (2)
• B
  3% (1)
• D
  91% (30)

Explanation

Option D is correct because Fee-for-service with utilization review, PPOs, and HMOs are all recognized major forms of managed care organizations - each uses different mechanisms to manage costs and care delivery, but all fall under the managed care umbrella. Options A, B, and C are not "wrong" as concepts; they are wrong only as standalone answers because each represents just one category, making any single-choice answer incomplete. A fee-for-service plan with utilization review controls costs by reviewing care necessity; a PPO contracts with a network of providers at discounted rates while allowing out-of-network use; an HMO coordinates care through a primary care gatekeeper with strict network requirements.

Memory tip: Think "FPH - Full Picture Here" (Fee-for-service, PPO, HMO) - when a question lists the three pillars of managed care and offers "all of the above," the complete picture is almost always the answer.

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