AHIP AHM-540 AHM Medical Management Exam Practice Test

One difference between outcomes research and clinical research is that outcomes research

The following statement(s) can correctly be made about the use of screening for secondary prevention:

Screening activities may involve specialty care providers as well as primary care providers (PCPs) and the health plan

Secondary prevention often results in more utilization of services immediately following screening

Screening focuses on members who have not experienced any symptoms of a particular illness

For this question, if answer choices (A) through (C) are all correct, select answer choice (D). Otherwise, select the one correct answer choice.

The QAPI (Quality Assessment Performance Improvement Program) is a Centers for Medicaid and Medicare Services (CMS) initiative designed to strengthen health plans' efforts to protect and improve the health and satisfaction of Medicare beneficiaries. QAPI quality assessment standards apply to

By definition, the development and implementation of parameters for the delivery of healthcare services to a health plan's members is known as

Demetrius Farrell, age 82, is suffering from a terminal illness and has consulted his health plan about the care options available to him. In order to avoid unwanted, futile interventions, Mr. Farrell signed an advance directive that indicates the types of end-of-life medical treatment he wants to receive. His family is to use this document as a guide should Mr. Farrell become incapacitated.

The document that Mr. Farrell is using to communicate his end-of-life healthcare wishes to his family is known as a

The Riverside Health Plan is considering the following provider compensation options to use in its contracts with several provider groups and hospitals:

A discounted fee-for-service (DFFS) payment system

A case rate system

Capitation

If Riverside wants to use only those compensation methods that encourage the efficient use of resources, then the compensation method(s) that Riverside should consider for its new contracts include

As a follow-up to a performance improvement plan for member services, the Stellar Health Plan conducted an evaluation of the success of the plan. Stellar conducted its evaluation as the plan was being carried out. The evaluation focused on specific activities and assessed the relative importance of those activities to the plan as a whole. This information indicates that Stellar's evaluation of the plan was both