—Payment And Quality Ch.12 Test Bank Answers Higbea

Chapter 12—Payment and Quality

Multiple Choice & True/False

1. Which of the following statements about payment model incentives is/are TRUE?

[1] Fee-for-service and capitation payment models have opposite incentives for the amount of treatment delivered

[2] Fee-for-service and capitation are provider centric and do not incent concern for patient quality or outcomes

[3] Fee-for-service and capitation are patient centric and incent concern for patient quality or outcomes

[4] 1. & 2.

[5] 1. & 3.

Subject: Chapter 12

Complexity: Difficult

Simplified Functional Taxonomy: Recall

1. When comparing the health systems of the US and OECD countries, which of the following statements is/are FALSE?

[1] The US always has the highest cost and highest quality

[2] The OECD countries always have the lowest cost and highest quality

[3] The US always has the highest cost and lowest quality

[4] The US has the largest global economy, largest research & production hub, & the lowest quality

[5] Until recently, the US has never tied quality or outcomes to payment

Subject: Chapter 12

Complexity: Moderate

Simplified Functional Taxonomy: Recall

1. Which of the following statements describes how patients view quality?

[1] Efficacy of treatment

[2] Adherence to evidence-based practice guidelines

[3] Treated with respect and dignity

[4] 1. & 2.

[5] 1. & 3.

Subject: Chapter 12

Complexity: Moderate

Simplified Functional Taxonomy: Recall

1. Which of the following statements describes how providers view quality?

[1] Efficacy of treatment

[2] Adherence to evidence-based practice guidelines

[3] Treated with respect and dignity

[4] 1. & 2.

[5] 1. & 3.

Subject: Chapter 12

Complexity: Difficult

Simplified Functional Taxonomy: Recall

1. Which of the following statements about evidence-based practice guidelines is/are FALSE?

[1] Clinical quality and treatment outcomes are based on adherence to evidence-based practice guidelines

[2] Evidence-based practice guidelines is based on clinical research

[3] Evidence-based practice guidelines are published in medical journals

[4] It takes 7 years to adopt evidence-based practice guidelines that become obsolete within 10 years

[5] It takes 17 years to adopt evidence-based practice guidelines that become obsolete within 10 years

Subject: Chapter 12

Complexity: Moderate

Simplified Functional Taxonomy: Recall

1. Which of the following statements about quality related events (2003) is/are FALSE?

[1] AHRQ launched its annual health quality & disparities reports

[2] Pay-for-performance program was launched rewarding physicians for adhering to evidence-based treatment guidelines

[3] Pay-for-performance increased physician payment & improved quality

[4] Current (2015) AHRQ reports indicate quality has improved

[5] Current (2015) AHRQ reports indicate disparities have not improved

Subject: Chapter 12

Complexity: Difficult

Simplified Functional Taxonomy: Recall

1. Which of the following statements about Patient Centered Medical Homes (PCMH) is/are TRUE?

[1] PCMHS began in 1967 by pediatrics with the purpose of care coordination

[2] PCMHs began in 1967 by adult PCPs with the purpose of care coordination

[3] Both PCMHs and the current payment model are patient centric

[4] PCMHs can easily be assimilated into current PCP models

[5] While the ACA encourages PCMHs, it provides no practice development funds

Subject: Chapter 12

Complexity: Difficult

Simplified Functional Taxonomy: Recall

1. Which of the following statements BEST describes Accountable Care Organizations (ACO)?

[1] ACOs are based on a Medicare waiver program that coordinated cardiac care

[2] ACOs are effective coordinating care but ineffective decreasing costs

[3] ACOs require risk sharing that is easily tolerated by provider organizations

[4] ACOs that left the program did so for operational reasons

[5] ACOs are developing at a rapid pace with CMS anticipating all payment models will be transitioned to negative and positive risk sharing models by 2017

Subject: Chapter 12

Complexity: Difficult

Simplified Functional Taxonomy: Recall

1. Which of the following statements about Value Based Purchasing (VBP) and episode of care payment models is/are FALSE?

[1] Both payment models positively reward quality of care

[2] VBP rewards are based on clinical quality outcomes

[3] VBP is a revenue neutral payment model

[4] Episode of care payment models provide payment incentives for keeping patients out of the hospital

[5] Episode of care payment successes have a geographical component

Subject: Chapter 12

Complexity: Difficult

Simplified Functional Taxonomy: Recall

1. Which of the following statements about payment models promulgated from the ACA is/are TRUE?

[1] ACA promulgated payment models have resulted in significant changes in delivery & payment for healthcare services

[2] ACA promulgated payment models have resulted in model redesign proceeding payment redesign

[3] ACA promulgated payment models based on outcomes is an innovative payment approach

[4] ACA promulgated payment models have resulted in a major organizational paradigm shift

[5] All of the above

Subject: Chapter 12

Complexity: Difficult

Simplified Functional Taxonomy: Recall

Short Answer & Essay

1. Describe the arc of healthcare payment change to improve quality.

Subject: Chapter 12

Complexity: Moderate

Simplified Functional Taxonomy: Recall

1. Describe the evolution of nonpayment-driven efforts to improve quality.

Subject: Chapter 12

Complexity: Moderate.

Simplified Functional Taxonomy: Recall.

1. Describe the interplay between private sector efforts and government efforts.

Subject: Chapter 12

Complexity: Moderate.

Simplified Functional Taxonomy: Recall.

1. Describe the forces leading to the linking of payment and quality in CMS policy.

Subject: Chapter 12

Complexity: Difficult.

Simplified Functional Taxonomy: Analysis.