AHIP Exam AHM-530 Topic 1 Question 96 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 96
Topic #: 1

Social health maintenance organizations (SHMOs) and Programs of All-Inclusive Care for the Elderly (PACE) are federal programs designed to provide coordinated healthcare services to the elderly. Unlike PACE, SHMOs

Aare reimbursed solely through Medicaid programs

Bprovide extensive long-term care

Care reimbursed on a fee-for-service basis

Dlimit benefits to a specified maximum amount

Show Suggested Answer

Suggested Answer: B

by Jeannetta at Sep 11, 2024, 01:37 PM

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Louvenia

6 months ago

I think option A is also important, especially for PCPs.

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Noble

6 months ago

I believe option B is correct, it compensates for any unusual factors.

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Avery

6 months ago

I agree, it helps account for differences in patient populations.

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Colette

6 months ago

As a provider, I'd be a bit nervous if my performance was judged without proper case mix/severity adjustments. Gotta level the playing field!

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Blair

4 months ago

D) Allow for a more equitable comparison of data between providers of outpatient care but not providers of inpatient care

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Zona

4 months ago

I agree, it's important to consider case mix and severity when evaluating provider performance.

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Leanna

4 months ago

C) Tend to increase the number of providers who are considered to be outliers

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Elizabeth

5 months ago

B) Help compensate for any unusual factors that may exist in a provider's patient population or in a particular patient

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Nell

5 months ago

C) Tend to increase the number of providers who are considered to be outliers

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Iluminada

5 months ago

B) Help compensate for any unusual factors that may exist in a provider's patient population or in a particular patient

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Cristy

5 months ago

A) Typically are more important in measuring the performance of PCPs than they are in measuring the performance of specialists

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Mohammad

6 months ago

A) Typically are more important in measuring the performance of PCPs than they are in measuring the performance of specialists

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Delsie

6 months ago

Option D doesn't make much sense - I'd expect case mix to be important for both inpatient and outpatient care, no?

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Nana

6 months ago

Hah, option C is just asking to create more 'problem children' providers. Not the way to go about it.

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Peggy

6 months ago

I agree, Option B is the best answer. Adjustments are key to making fair comparisons between providers with different patient mixes.

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Kristel

5 months ago

I agree, Option B is the best answer. Adjustments are key to making fair comparisons between providers with different patient mixes.

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Suzi

5 months ago

B) Help compensate for any unusual factors that may exist in a provider's patient population or in a particular patient

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Alyce

6 months ago

A) Typically are more important in measuring the performance of PCPs than they are in measuring the performance of specialists

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Rosendo

6 months ago

Option B seems the most comprehensive in addressing how case mix/severity adjustments can help account for factors in a provider's patient population.

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