← Back to exam page

AHM-530 – Network Management

Loading demo links...

Showing 1–3 of 15 questions

Question 1 (Volume B)

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:

Select an option, then click Submit answer.

  • ○

    Typically are more important in measuring the performance of PCPs than they are in measuring the performance of specialists
  • ○

    Help compensate for any unusual factors that may exist in a provider's patient population or in a particular patient
  • ○

    Tend to increase the number of providers who are considered to be outliers
  • ○

    Allow for a more equitable comparison of data between providers of outpatient care but not providers of inpatient care
Question 2 (Volume A)

Many health plans opt to carve out behavioral healthcare (BH) services. However, one argument against carving out BH services is that this action most likely can result in

Select an option, then click Submit answer.

  • ○

    Slower access to BH care for plan members

  • ○

    Increased collaboration between BH providers and PCPs

  • ○

    Fewer specialized BH services for plan members

  • ○

    Decreased continuity of BH care for plan members
Question 3 (Volume A)

Lakesha Frazier, a member of a health plan in a rural area, had been experiencing heart palpitations and shortness of breath. Ms. Frazier’s primary care provider (PCP) referred her to a local hospital for an electrocardiogram. The results of the electrocardiogram were transmitted for diagnosis via high-speed data transmission to a heart specialist in a city 500 miles away. This information indicates that the results of Ms. Frazier’s electrocardiogram were transmitted using a communications system known as

Select an option, then click Submit answer.

  • ○

    A narrow network

  • ○

    An integrated healthcare delivery system

  • ○

    Telemedicine

  • ○

    Customized networking