北美精算师——SOA真题系列精选2003年度11月Course8M（一），这是我们高顿网校小编给大家罗列的。
 
　　Subject: Quality Dental Coverage with 3 Months at No Charge
　　Affordable Dental Coverage
　　?  save up to 60% on all your dental needs
　　?  choose from 15 of the finest nationwide and regional plans
　　?  pay premiums, submit claims, get the latest information, all on your desktop!
　　(a) List the general types of delivery systems for dental plans and their major
　　features.
　　(b) Outline plan provisions and claim practices that dental insurers can use to
　　limit cost and anti-selection.
　　(c) Describe challenges that e-commerce companies must overcome to be
　　successful.
　　COURSE 8: Fall 2003 - 11 - GO TO NEXT PAGE
　　Managed Care Segment
　　Afternoon Session
　　Questions 15 - 18 pertain to the case study
　　15. (4 points) The Bedford Group is exploring alternatives to acute inpatient care. A study
　　by Bedford’s Medical Director indicates the MCO might benefit from a program to
　　encourage patients with conditions requiring less intensive treatment to be moved from
　　acute care facilities to a Skilled Nursing Facility (SNF). The initiative would transfer
　　acute care patients to the SNF at Hospital ID1 and is expected to result in the following
　　changes:
　　Reduction in
　　Medical Acute Days
　　Reduction in
　　Surgical Acute Days
　　Hosp ID1 1.0% 0.5%
　　Hosp ID2 2.0% 2.0%
　　Hosp ID3 1.5% 1.0%
　　(a) Assuming the above reductions are realized, and based on Table MC-2, calculate
　　the expected change in medical, surgical and SNF days/1000 and the change in
　　medical/surgical length of stay in 2002 for the MCO. Show your work.
　　(b) Describe behavioral health channeling mechanisms available to direct individuals
　　to the appropriate type of care.
　　COURSE 8: Fall 2003 - 12 - GO TO NEXT PAGE
　　Managed Care Segment
　　Afternoon Session
　　Questions 15 - 18 pertain to the case study
　　高顿网校之名人思想：每个人的生命都是一只小船，梦想是小船的风帆。