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

Limited Time Offer

25%

Off

Get Premium AHM-530 Questions as Interactive Web-Based Practice Test or PDF

Contribute your Thoughts:

Submit Cancel

Louvenia

3 months ago

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

upvoted 0 times

...

Noble

3 months ago

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

upvoted 0 times

...

Avery

3 months ago

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

upvoted 0 times

...

Colette

3 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!

upvoted 0 times

Blair

1 months ago

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

upvoted 0 times

...

Zona

1 months ago

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

upvoted 0 times

...

Leanna

1 months ago

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

upvoted 0 times

...

Elizabeth

2 months ago

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

upvoted 0 times

...

Nell

2 months ago

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

upvoted 0 times

...

Iluminada

2 months ago

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

upvoted 0 times

...

Cristy

2 months ago

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

upvoted 0 times

...

Mohammad

2 months ago

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

upvoted 0 times

...

Delsie

3 months ago

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

upvoted 0 times

...

Nana

3 months ago

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

upvoted 0 times

...

Peggy

3 months ago

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

upvoted 0 times

Kristel

2 months ago

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

upvoted 0 times

...

Suzi

2 months ago

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

upvoted 0 times

...

Alyce

3 months ago

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

upvoted 0 times

...

Rosendo

3 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.

upvoted 0 times