Question

Doctors who are assigned to sponsors and who are also part of the TRICARE provider network are called?

1) health maintenance organizations
2) point-of-service plans
3) preferred provider networks
4) primary care managers

Answer 1

Doctors part of the TRICARE provider network assigned to sponsors are referred to as primary care managers. They play a crucial role in managing patient care within the military health system. In contrast to fee-for-service models, HMOs provide a fixed reimbursement which handles the moral hazard of overutilization.

Step-by-step explanation:

Doctors who are assigned to sponsors and are also part of the TRICARE provider network are called primary care managers (PCMs). The TRICARE system is associated with the U.S. military health system and offers healthcare services to military personnel, retirees, and their dependents. PCMs are responsible for providing care to their patients within this network and managing referrals to specialists.

The key difference between a fee-for-service healthcare system and one based on health maintenance organizations (HMOs) is in the method of reimbursement. In a fee-for-service arrangement, providers get paid for every service they deliver, while in an HMO, providers are paid a set fee per enrolled individual, regardless of the number of services provided. This shift in healthcare provision aims to manage costs and reduce the moral hazard of overutilization inherent in a fee-for-service model.