A nurse was considering self-employment by starting a home health managed care agency. Which of the following risks is the nurse taking, particularly in the beginning?

Question

a. Because the nurse is a newcomer, most patient referrals may go to other, more long-term agencies.
b. Managed care agencies assume the risk of providing all needed care within the amount budgeted.
c. Most clients would not know the nurse and therefore would be unaware of the nurse's agency.
d. Other nurses may envy the successful nurse and withdraw their friendship and support.

Answer 1

ANS: B
Managed care agencies contract with payers, such as insurance companies, to provide specified services to the enrolled clients at a predetermined price. Managed care agencies receive payment before offering services and are responsible for taking the financial risk of providing care to patients within the budgeted allotment. The nurse will not need to worry about patient referrals or personally knowing the clients before referral as this home care agency is part of a managed care group that has enrolled clients that need services. Envy from other nurses is not a risk faced by the nurse starting this business endeavor.