Deck 16: Case and Population Health Management

Question 1

A concept involving a system that guides and tracks patients over time through a comprehensive array of health services to span all levels of intensity of care is known as:

A) transition of care.
B) continuum of care.
C) rounds.
D) disease management strategies.

Answer 1

continuum of care.

Question 2

Community health means meeting the:

A) collective needs of a group by identifying problems and managing interactions.
B) needs of an individual within the community by identifying problems and managing interactions.
C) needs of the health care system within a population or area.
D) needs of a population by identifying problems and managing interactions.

Answer 2

collective needs of a group by identifying problems and managing interactions.

Question 3

A patient has a history of diabetes mellitus, myocardial infarctions, and hypertension. His HgbA?c level dropped from 7.8% to 6.2% 2 months after he began a walking exercise program. The nurse case manager had provided diabetic education and suggested ways to enhance his cardiac reserve. This is an example of:

A) nursing empowerment.
B) nursing knowledge.
C) patient expertise.
D) patient participation in care.

Answer 3

patient participation in care.

Question 4

The nurse who uses collaboration to coordinate care for an individual's and family's comprehensive health needs through communication and available resources to promote patient safety and quality, cost-effective outcomes is performing:

A) population health management.
B) managed care.
C) disease management.
D) case management.

Question 5

Nursing outreach programs are the core element of:

A) population health management.
B) disease management.
C) case management.
D) care management.

Question 6

_____ has garnered considerable attention in health care in part because of the publication Crossing the Quality Chasm, a health care quality initiative of the Institute of Medicine (IOM, now called the National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division).

A) Disease management
B) Development research groups
C) Case management
D) Diagnosis-related groups

Question 7

Which of the following collaborative processes assesses, plans, facilitates, coordinates, advocates, and evaluates options and services required to meet an individual's comprehensive health needs?

A) Care management
B) Case management
C) Disease management
D) Population health management

Question 8

According to the Centers for Disease Control (CDC), chronic diseases account for _____% of deaths in the United States.

A) 20
B) 40
C) 50
D) 70

Question 9

A health care management continuum:

A) deals strictly with health promotion.
B) controls problems at the population level.
C) is a linkage of health services across settings.
D) provides another health care option for the homeless.

Question 10

The hospital's disease management program has gathered data collected from health assessments in order to categorize patients into like groups with the intention of providing population management interventions. This practice or strategy is referred to as:

A) analogizing.
B) stratification.
C) comparing.
D) data exchanging.

Question 11

Which of the following factors best suggests an individual is motivated to engage in a disease management program?

A) Mistrust of insurance companies
B) Enrollment at initial contact
C) Can afford the cost of enrollment
D) Has a need that would benefit from the program

Question 12

The brokerage model and the comprehensive service center model are examples of which type of care model?

A) Collaborate
B) Inter-professional
C) Interdisciplinary
D) Social work

Question 13

Which of the following statements is true about the New England Medical Center (NEMC) case management model?

A) It has a client-centered approach instituted during episodes of acute illness.
B) It is known as a beyond-the-walls, medical-social, across-the-continuum of care model.
C) It emphasizes the case manager's traditional linkage function.
D) CM functions are undertaken as a part or an extension of therapeutic intervention.

Question 14

The Collaborative Care Model of CM is best used for:

A) patients with co-occurring physical and mental health needs.
B) individuals and small systems.
C) hospital-based case management programs focusing on episodic care.
D) the transition of high-risk clients from acute care to community or long-term care settings.

Question 15

Which of the following scenarios would require disease management?

A) A blood pressure screening clinic is started at the senior citizen center.
B) A person with multiple chronic illnesses is admitted to the hospital.
C) A program is started to address diabetes in the Native American population.
D) An initiative is developed to promote fluoride treatments in schools.

Question 16

The core element common to all provider interventions in case management (CM), disease management (DM), and population health management (PHM) is:

A) disease preventative care.
B) care coordination.
C) client-centered.
D) population-focused.

Question 17

A disease management program usually focuses on patients with:

A) chronic conditions.
B) mental health issues.
C) outpatient procedures.
D) surgical diagnoses.

Question 18

A population health approach:

A) aims to improve the health of the entire population.
B) is funded by local, state, and national governments.
C) strives to care for people who already exhibit optimal health.
D) treats community-acquired diseases in area clinics.

Question 19

The first step in the development of a case management program is:

A) to identify high-volume or high-risk case types.
B) to develop a pilot program.
C) to assess the organization and the client population served.
D) to form an interdisciplinary care team.

Question 20

To be effective at population care management, both CM and DM need to:

A) assess and plan health initiatives within an area.
B) implement and evaluate health programs within a community.
C) assess and define the populations to be served.
D) organize and regulate health professions across the country.

Question 21

The CM dyad team model-composed of a nurse case manager and social worker-has been widely adopted in hospitals. Through its unique structure, the nurse and social work dyad provides the implementation of collaborative interventions that focus on: (Select all that apply.)

A) minimization of inpatient transitions.
B) promotion of patient and family satisfaction through efforts of advocacy.
C) maximization of health care benefits.
D) reduction of cost by decreasing the length of stay.
E) enhanced discharge planning.

Question 22

Which of the following components are common to all case management models? (Select all that apply.)

A) Client identification and outreach
B) Population management
C) Monitoring service delivery
D) Individual assessment and diagnosis
E) Evaluation
F) Environmental management

Question 23

Case management and disease management are similar because both are interventions designed to coordinate care for better outcomes and lowered costs. Which statements are true regarding the differences between the two terms? (Select all that apply.)

A) Disease management is client focused.
B) Case management focuses on coordinating care of individuals and families.
C) Disease management is more population-based than client-centered.
D) Disease management is more episodic in its approach.
E) Case management is more population-focused.

Question 24

Population health management (PHM) is viewed as a major health care strategy to improve health outcomes. This is because effective population health management programs: (Select all that apply.)

A) have proactive interventions.
B) promote client satisfaction through advocacy.
C) coordinate care for chronic conditions.
D) have consistency of care for at-risk populations.
E) customize care support.
F) encourage adherence to treatment.

Question 25

Which of the following governmental agencies tracks population and health trends? (Select all that apply.)

A) U.S. Census Bureau
B) The Joint Commission
C) CDC
D) Bureau of Labor Statistics (BLS)
E) Health Resources and Services Administration (HRSA)

Question 26

Which of the following statements accurately describe disease management? (Select all that apply.)

A) Disease management is care coordination that is organized to achieve specific client outcomes, given fiscal and other resource constraints.
B) Disease management is a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant.
C) Disease management relies on a structured system of interventions that focus on a specific condition.
D) Disease management program content and interventions are evidence and guideline based.
E) Disease management is the medical management of chronic disease.