Free AHM-540 Exam Braindumps

Various government and independent agencies have created tools to measure and report the quality of healthcare. One performance measurement tool that was developed by the Agency for Healthcare Research and Quality (AHRQ) is

1. A. the Health Plan Employer Data and Information Set (HEDIS®), which is a report card system for hospitals and long-term care facilities
2. B. HEDIS, which is a performance measurement tool that addresses both effectiveness of care and plan member satisfaction
3. C. the Consumer Assessment of Health Plans (CAHPS®), which was established to develop and implement a national strategy for quality measurement and reporting
4. D. CAHPS, which is a tool that measures consumer satisfaction with specific aspects of health plan services

Correct Answer: D

One method of transferring the information in electronic medical records (EMRs) is through a health information network (HIN). The following statements are about HINs. Three of the statements are true and one is false. Select the answer choice containing the FALSE statement.

1. A. A HIN may afford a health plan better measurements of outcomes and provider performance.
2. B. The use of a HIN typically increases a health plan’s exposure to liability for poor care.
3. C. Most HINs are Internet-based rather than built on proprietary computer networks.
4. D. Currently, the majority of health plans do not have HINs that are capable of transferring medical records among their network providers.

Correct Answer: B

Emilio Martinez, a member of the Bloom Health Plan, has recently been diagnosed with prostate cancer by his physician, Dr. Robert Cohen. Mr. Martinez has decided to participate in Bloom’s shared decision-making program for prostate cancer. On the basis of this information, it is most likely correct to say
* 1. That verification of Mr. Martinez’s understanding about his care options protects both Dr. Cohen and Bloom against charges of malpractice
* 2. That Mr. Martinez and Dr. Cohen will discuss the care options available to Mr. Martinez, but the ultimate decision about care is up to Dr. Cohen

1. A. Both 1 and 2
2. B. 1 only
3. C. 2 only
4. D. Neither 1 nor 2

Correct Answer: D

The paragraph below contains two pairs of terms in parentheses. Determine which term in each pair correctly completes the paragraph. Then select the answer choice containing the two terms that you have chosen.
Health plans use both internal and external standards to assess the quality of the services that they provide. (Internal / External) standards are based on information such as published industry-wide averages or best practices of recognized industry leaders. Health plans primarily rely on (internal / external) standards to evaluate healthcare services.

1. A. Internal / internal
2. B. Internal / external
3. C. External / internal
4. D. External / external

Correct Answer: D

Benchmarking is a quality improvement strategy used by some health plans. With regard to benchmarking, it is correct to say that

1. A. cost-based benchmarking reveals why some areas of a health plan perform better or worse than comparable areas of other organizations
2. B. diagnosis-related groups (DRGs) are a source of benchmarking data that describe individual procedures and cover both inpatient and outpatient care
3. C. patient billing records provide a much more accurate account of procedure costs for benchmarking than do current procedural terminology (CPT) codes
4. D. the focus of benchmarking for health plan has shifted from identifying the lowest cost practices to identifying best practices

Correct Answer: D