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AHIP Exam AHM-530 Topic 3 Question 85 Discussion

Actual exam question for AHIP's AHM-530 exam
Question #: 85
Topic #: 3
[All AHM-530 Questions]

The provider contract that the Canyon health plan has with Dr. Nicole Enberg specifies that she cannot sue or file any claims against a Canyon plan member for covered services, even if Canyon becomes insolvent or fails to meet its financial obligations. The contract also specifies that Canyon will compensate her under a typical discounted fee-for-service (DFFS) payment system.

During its recredentialing of Dr. Enberg, Canyon developed a report that helped the health plan determine how well she met Canyon's standards. The report included cumulative performance data for Dr. Enberg and encompassed all measurable aspects of her performance. This report included such information as the number of hospital admissions Dr. Enberg had and the number of referrals she made outside of Canyon's provider network during a specified period. Canyon also used process measures, structural measures, and outcomes measures to evaluate Dr. Enberg's performance.

Canyon used a process measure to evaluate the performance of Dr. Enberg when it evaluated whether:

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Suggested Answer: A

by Avery at Apr 25, 2024, 04:02 PM

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Caprice
6 months ago
That makes sense, ensuring patients receive appropriate immunizations is an important aspect of primary care.
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Nelida
6 months ago
I think it was about whether Dr. Enberg's young patients receive appropriate immunizations at the right ages.
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Rory
6 months ago
Do you know what specific process measure Canyon used?
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Nelida
6 months ago
Yes, I believe Canyon used process measures to evaluate her performance.
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Rory
7 months ago
I think the question is about how Canyon evaluated Dr. Enberg's performance.
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Hoa
7 months ago
Exactly, we must always strive for excellence in healthcare.
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Omega
7 months ago
For sure, it's crucial for maintaining high-quality healthcare standards.
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Madonna
7 months ago
Yeah, it's a complex but important topic.
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Hoa
7 months ago
No problem, happy to talk about healthcare performance measures.
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Omega
7 months ago
Well, I learned something new today. Thanks for the discussion.
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Madonna
7 months ago
Absolutely, that should always be the priority.
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Hoa
7 months ago
It's all about ensuring quality care for the patients.
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Omega
7 months ago
I agree, it gives a clearer picture of how effective the care is.
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Madonna
7 months ago
Definitely, outcomes measures are crucial in evaluating performance.
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Hoa
7 months ago
Yeah, it's important to consider the outcomes of the treatments provided.
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Omega
7 months ago
I see, I guess it could be C) as well.
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Madonna
7 months ago
Oh, that's interesting. I didn't think of that.
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Hoa
7 months ago
Actually, I believe the answer is C) The condition of one of Dr. Enberg's patients improved after the patient received medical treatment from Dr. Enberg.
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Omega
7 months ago
I'm not sure, I think it might be B) Dr. Enberg's young patients receive appropriate immunizations at the right ages.
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Madonna
7 months ago
I think the answer is A) Dr. Enberg's young patients receive appropriate immunizations at the right ages.
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