Question 1

Which of the following is not an alternative payment model:&#10;A) Merit Based Physician Incentive Payment&#10;B) Health Insurance Portability and Accountability Act (HIPAA)&#10;C) Accountable Care Organization&#10;D) Bundled Payment for Care Improvement

Accepted Answer

HIPAA is a federal law that provides data privacy and security provisions for safeguarding medical information, not an alternative payment model.

Question 2

An Accountable Care Organization's goals include the following except:&#10;A) Improved outcomes for patients&#10;B) Lower total cost of care&#10;C) Increase in Emergency Room Department visits and hospital admissions&#10;D) Improved care coordination

Accepted Answer

Accountable Care Organizations aim to improve patient outcomes, lower costs, and enhance care coordination, not to increase ER visits and hospital admissions.

Question 3

Strategies to improve an Accountable Care Organization's performance include all except:&#10;A) The ability to risk stratify populations&#10;B) Proactive management of patient attribution&#10;C) Identification of and preferential referral to high-value providers&#10;D) Paying physicians for participation

Accepted Answer

Paying physicians for participation does not directly improve an ACO's performance. Instead, performance is enhanced through strategic management and care coordination, such as risk stratification, patient attribution, and referrals to high-value providers.

Question 4

Patient-Centered Medical Home tenets include:&#10;A) Access to Care&#10;B) Physician availability seven days per week&#10;C) Use of Advanced Practice Providers&#10;D) Hospital admitting privileges

Accepted Answer

The Patient-Centered Medical Home model emphasizes providing patients with access to care, which includes timely appointments, after-hours care, and electronic communication.

Question 5

Care Coordination is all of the following except:&#10;A) Ensuring follow up from specialist visits&#10;B) Understanding where patients are on the continuum of care&#10;C) Aimed at managing the sickest and most at risk patients&#10;D) Exclusively performed by a Social Worker

Accepted Answer

Care coordination is a collaborative process that involves various healthcare professionals, not exclusively social workers, to ensure that patients receive comprehensive and continuous care.

Question 6

Bundled payment models require coordinating the care provided by&#10;A) Hospitals&#10;B) Specialists&#10;C) Skilled Nursing Facilities&#10;D) All of the above

Accepted Answer

Bundled payment models involve a single payment for all services related to a treatment or condition, requiring coordination among hospitals, specialists, and skilled nursing facilities to manage costs and care quality effectively.

Question 7

Services that Medicare now covers under their regular physician fee schedule that align with coordinated care include&#10;A) Telephonic check in with patient&#10;B) Transition of Care management for 30 days&#10;C) Chronic Care Management for 30 days&#10;D) All of the above

Accepted Answer

Medicare covers telephonic check-ins, transition of care management, and chronic care management under their regular physician fee schedule, as these services align with coordinated care efforts.

Question 8

The Comprehensive Primary Care Plus program is an Alternative Payment Model which&#10;A) Applies only to Medicare patients&#10;B) Pays a monthly care coordination fee per patient to the PCP&#10;C) Pays specialists a bonus for good chronic disease management&#10;D) Penalizes hospitals for readmissions

Accepted Answer

The Comprehensive Primary Care Plus (CPC+) program is designed to improve primary care through a monthly care coordination fee paid to primary care providers (PCPs) for managing patient care, rather than focusing solely on Medicare patients or penalizing hospitals.

Question 9

An Accountable Care Organization is responsible for coordinating all except&#10;A) Hospitalizations out of area&#10;B) Home Health services&#10;C) Price of medications&#10;D) Chronic disease management

Accepted Answer

Accountable Care Organizations (ACOs) focus on coordinating care to improve quality and reduce costs, but they do not directly control or set the prices of medications.

Question 10

The technology-based tool that has the biggest benefit to care coordination is:&#10;A) Blood glucose monitoring in patients with diabetes&#10;B) Real-time alerts to care team of patient's emergency department visits&#10;C) Text messaging between physicians&#10;D) Electronic prescribing

Accepted Answer

Real-time alerts to the care team about a patient's emergency department visits enable immediate communication and coordination among healthcare providers, ensuring timely and appropriate follow-up care, which is crucial for effective care coordination.

Deck 12: Coordinated Care Delivery Models