AHIP Exam AHM-530 Topic 4 Question 104 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 104
Topic #: 4

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 Gerry at Dec 10, 2024, 10:46 PM

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Hillary

3 days ago

I'd go with B as well. Ignoring case mix would be like comparing apples to oranges.

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Kenny

5 days ago

I think option B is the correct answer, as it mentions compensating for unusual factors in patient populations.

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Alberto

8 days ago

I agree, B seems like the best answer. Adjustments are needed to level the playing field.

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Laura

9 days ago

I believe they can also prevent unfairly labeling providers as outliers.

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Winfred

12 days ago

I agree, they help account for differences in patient populations.

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Leonida

19 days ago

Definitely B. Accounting for patient population factors is crucial to accurately assess provider performance.

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Iraida

19 days ago

I think case mix/severity adjustments are crucial in evaluating provider success.

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