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AHIP Exam AHM-530 Topic 6 Question 105 Discussion

Actual exam question for AHIP's AHM-530 exam
Question #: 105
Topic #: 6
[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 Iluminada at Jan 12, 2025, 10:59 AM

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Elinore
1 months ago
I think the answer is B. Checking immunization rates for young patients is a common way to evaluate a provider's performance. As for the humorous comment - I hope Dr. Enberg doesn't give her patients any 'Canyon-style' immunizations!
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Timothy
5 days ago
I think the answer is B. Checking immunization rates for young patients is a common way to evaluate a provider's performance.
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Goldie
1 months ago
Hmm, this is a tricky one. I'm going to go with D - evaluating Dr. Enberg's procedures for ensuring patients' access to medical care. That sounds like it could be a useful process measure too.
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Corazon
29 days ago
User 2: I agree. Dr. Enberg's procedures should definitely be evaluated for that.
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Jolene
1 months ago
User 1: I think D is a good choice. It's important for patients to have access to medical care.
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Arlean
2 months ago
I'm not sure, but I think A might be correct. The question mentions that Canyon is evaluating Dr. Enberg's performance, and checking if her young patients receive appropriate immunizations seems like it could be a relevant process measure.
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Jerry
2 months ago
Well, since the question is asking about a process measure, I think the correct answer is B. Evaluating whether Dr. Enberg's young patients receive appropriate immunizations at the right ages seems like a classic example of a process measure.
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Larae
1 months ago
Yes, making sure young patients receive appropriate immunizations at the right ages is definitely a key aspect of a process measure.
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Matilda
1 months ago
I agree, option B seems like the most appropriate process measure for evaluating Dr. Enberg's performance.
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Fannie
2 months ago
Yes, I think the answer might be A) Dr. Enberg's young patients receive appropriate immunizations at the right ages because it's a process measure related to patient care.
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Paulene
2 months ago
I agree. It seems like the answer could be related to the quality of care provided to young patients.
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Fannie
2 months ago
I think the question is asking about how Dr. Enberg's performance is evaluated.
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