AHIP Exam AHM-530 Topic 3 Question 89 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 89
Topic #: 3

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 Ernest at Jun 03, 2024, 05:43 PM

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Carrol

5 months ago

I think the key here is that case mix/severity adjustments allow for a more apples-to-apples comparison between providers. Option B captures that perfectly.

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Candra

4 months ago

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

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Charlie

4 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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Louann

4 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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Salome

4 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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Margarett

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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German

5 months ago

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

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Rolande

5 months ago

Haha, option D is a good one. Trying to compare outpatient and inpatient providers without adjusting for case mix is like trying to compare apples and oranges. Good luck with that!

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Johnna

5 months ago

Option C is interesting, but I don't think that's the right answer. If anything, these adjustments should help reduce the number of outliers by leveling the playing field.

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Chuck

4 months ago

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

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Deonna

4 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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Monroe

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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Telma

5 months ago

I agree. They help account for differences in patient populations.

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Vince

5 months ago

I think case mix/severity adjustments are crucial for fair evaluations.

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Altha

6 months ago

I agree with Emilio. These adjustments are crucial to ensure we're not unfairly penalizing providers who happen to have more complex or high-risk patients.

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Emilio

6 months ago

Option B is the correct answer. Case mix/severity adjustments help account for differences in the patient populations that providers serve, which is important for fair performance measurement.

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