AHIP Exam AHM-530 Topic 1 Question 96 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 96
Topic #: 1

When evaluating the success of providers in meeting standards, a health plan must make adjustments for case mix or severity. One true statement about case mix/severity adjustments is that they:

ATypically are more important in measuring the performance of PCPs than they are in measuring the performance of specialists

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

CTend to increase the number of providers who are considered to be outliers

DAllow for a more equitable comparison of data between providers of outpatient care but not providers of inpatient care

Show Suggested Answer

Suggested Answer: B

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

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Louvenia

1 months ago

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

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Noble

1 months ago

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

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Avery

1 months ago

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

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Colette

1 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

18 hours 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

2 days ago

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

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Leanna

3 days ago

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

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Elizabeth

10 days 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

11 days ago

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

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Iluminada

22 days 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

26 days 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

1 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

2 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

2 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

2 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

21 days 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

24 days 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

1 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

2 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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