Free AHM-540 Exam Braindumps

Determine whether the following statement is true or false: Participation in disease management programs is currently voluntary.

1. A. True
2. B. False

Correct Answer: A

The following statements are about risk management for case management. Three of the statements are true and one is false. Select the answer choice containing the FALSE statement.

1. A. The use of a signed consent authorization form is consistent with accrediting agency standards for patient privacy and confidentiality of medical information.
2. B. Case management that is initiated after a member has incurred substantial medical expenses is more likely to be viewed as a tool to cut costs rather than to improve outcomes.
3. C. Health plan documents indicating that any case management delegates are separate, independent entities may reduce an health plan's exposure to risk.
4. D. A case management file cannot be used to support the health plan's position in the event of a lawsuit.

Correct Answer: D

Health plans conduct evaluations on the efficiency and effectiveness of their quality improvement activities. With regard to the effectiveness of quality improvement plans, it is correct to say that

1. A. effectiveness is the relationship between what the organization puts into an improvement plan and what it gets out of the plan
2. B. effectiveness is measured by reviewing outcomes to determine the accuracy or appropriateness of the strategy and the adequacy of resources allocated to that strategy
3. C. the effectiveness of an action plan is typically measured with a concurrent evaluation
4. D. an evaluation of plan effectiveness produces one of two results: the plan either (a) achieved the desired outcomes or (b) did not achieve the desired outcomes and is unlikely to do so under current conditions

Correct Answer: B

The following statements are about chronic and disabling conditions among children eligible for Medicaid. Three of the statements are true and one is false. Select the answer choice containing the FALSE statement.

1. A. Children with chronic conditions use more physician and nonphysician professional services than do children in the general population.
2. B. The majority of chronic conditions affecting children in Medicaid programs are the same as those affecting children in the general population.
3. C. Medicaid-eligible children are at risk for seriousmental and physical conditions.
4. D. Children in Medicaid programs have a higher incidence of chronic disabling conditions than do children in the general population.

Correct Answer: B

In recent years, the demand for prescription drugs has increased dramatically. Factors that have contributed to this increase include

1. A. increased education regarding the purpose and benefits of drug formularies
2. B. reductions in the cost of prescription drugs
3. C. increased use of direct-to-consumer (DTC) advertising
4. D. all of the above

Correct Answer: C