Free AHM-540 Exam Braindumps

The paragraph below contains an incomplete statement. Select the answer choice containing the term that correctly completes the paragraph.
Definitions of quality healthcare vary; however, four dimensions are essential to quality healthcare services. _____ is the quality dimension indicating that services result in the best care for a given cost or the lowest cost for a given level of care.

1. A. Accessibility
2. B. Effectiveness
3. C. Acceptability
4. D. Efficiency

Correct Answer: D

The case management team at the Hightower Health Plan reviewed the medical records of the following two plan members to determine the type of care each one needs and the most appropriate setting for that care:
Ira Morton was hospitalized for a severe stroke. Although his medical condition is stable, the stroke left him partially paralyzed and he will require extensive rehabilitation and 24- hour medical care.
Theresa Finley is recovering from a total hip replacement and is in need of short-term physical therapy and twice-weekly visits from a licensed nurse to check her blood pressure and the healing of her incision.
From the answer choices below, select the response that correctly identifies the level of care that would be most appropriate for Mr. Morton and Ms. Finley.

1. A. M
2. B. Morton-acute care M
3. C. Finley-subacute care
4. D. M
5. E. Morton-palliative care M
6. F. Finley-acute care
7. G. M
8. H. Morton-subacute care M
9. I. Finley-skilled care
10. J. M
11. K. Morton-skilled care M
12. L. Finley-palliative care

Correct Answer: C

One method that health plans use to address provider compliance with formularies is academic detailing.

1. A. True
2. B. False

Correct Answer: A

The paragraph below contains two pairs of terms or phrases enclosed in parentheses. Determine which term or phrase in each pair correctly completes the paragraph. Then select the answer choice containing the terms or phrases that you have chosen.
The Millway Health Plan received a 15% reduction in the price of a particular pharmaceutical based on the volume of the drug Millway purchased from the manufacturer. This reduction in price is an example of a (rebate / price discount) and (is / is not) dependent on actual provider prescribing patterns.

1. A. rebate / is
2. B. rebate / is not
3. C. price discount / is
4. D. price discount / is not

Correct Answer: D

Many health plans use HRA to target their preventive care programs to the healthcare needs of their members. With regard to HRA, it is correct to say that

1. A. Health plans rarely delegate HRA activities to external entities
2. B. Health plans typically focus their HRA efforts on newly enrolled members
3. C. HRA focuses on clinical data for an entire population and does not include demographic information that might identify individual members
4. D. HRA is generally a reliable predictor of medical resource utilization

Correct Answer: B