AHM-540 Free Practice Test

Comparing the quality of managed Medicare programs with the quality of FFS Medicare programs is often difficult. Unlike FFS Medicare, managed Medicare programs

1. A. can measure and report quality only at the provider level
2. B. use a single system to deliver services to all plan members
3. C. provide an organizational focus for accountability
4. D. can use the same performance measures for all products and plans

Correct Answer: C

Skilled nursing facilities (SNFs) are required by law to have formal programs for quality improvement and to monitor these programs using established standards. These requirements are described in
* 1.The Omnibus Budget Reconciliation Act (OBRA) of 1986
* 2.The Balanced Budget Act (BBA) of 1997

1. A. Both 1 and 2
2. B. 1 only
3. C. 2 only
4. D. Neither 1 or 2

Correct Answer: B

The Carlyle Health Plan uses the following clinical outcome measures to evaluate its diabetes and asthma disease management programs:
Measure 1: The percentage of diabetic patients who receive foot exams from their providers according to the program’s recommended guidelines Measure 2: The number of asthma patients who visited emergency departments for acute asthma attacks
From the answer choices below, select the response that correctly identifies whether these measures are true outcome measures or intermediate outcome measures. Measure 1- Measure 2-

1. A. Measure 1-true outcome measure Measure 2-true outcome measure
2. B. Measure 1-true outcome measure Measure 2-intermediate outcome measure
3. C. Measure 1-intermediate outcome measure Measure 2-true outcome measure
4. D. Measure 1-intermediate outcome measure Measure 2-intermediate outcome measure

Correct Answer: C

Performance variance can be classified as either common cause variance or special cause variance. The following statement(s) can correctly be made about special cause variance:
* 1. Inadequate staffing levels, employee errors, and equipment malfunctions are examples of special cause variance
* 2. Special cause variance is typically more difficult to detect and correct than is common cause variance

1. A. Both 1 and 2
2. B. 1 only
3. C. 2 only
4. D. Neither 1 nor 2

Correct Answer: B

The following statements are about chronic and disabling conditions among children eligible for Medicaid. Three of the statements are true and one is false. Select the answer choice containing the FALSE statement.

1. A. Children with chronic conditions use more physician and nonphysician professional services than do children in the general population.
2. B. The majority of chronic conditions affecting children in Medicaid programs are the same as those affecting children in the general population.
3. C. Medicaid-eligible children are at risk for seriousmental and physical conditions.
4. D. Children in Medicaid programs have a higher incidence of chronic disabling conditions than do children in the general population.

Correct Answer: B