AHM-540 Free Practice Test

One difference between outcomes research and clinical research is that outcomes research

1. A. provides an absolute measure of treatment results, whereas clinical research provides a relative measure of results
2. B. focuses on treatment effectiveness, whereas clinical research focuses on treatmentefficacy
3. C. examines diseases and treatments in isolation, whereas clinical research considers the effects of changes in health status and quality of life
4. D. gathers outcomes data from controlled clinical trials, whereas clinical research collects and analyzes clinical, financial, and administrative data

Correct Answer: B

The Riverside Health Plan is considering the following provider compensation options to use in its contracts with several provider groups and hospitals:
* 1. A discounted fee-for-service (DFFS) payment system
* 2. A case rate system
* 3. Capitation
If Riverside wants to use only those compensation methods that encourage the efficient use of resources, then the compensation method(s) that Riverside should consider for its new contracts include

1. A. 1, 2, and 3
2. B. 1 and 2 only
3. C. 2 and 3 only
4. D. 3 only

Correct Answer: C

Determine whether the following statement is true or false:
Immunization programs are a direct means of reducing health plan members’ needs for healthcare services and are typically cost-effective.

1. A. True
2. B. False

Correct Answer: A

Private employers are key purchasers of health plan services. The following statement(s) can correctly be made about employer expectations about the quality and cost- effectiveness of healthcare services:
* 1. For both health maintenance organizations (HMOs) and non-HMO plans, employers typically have access to accreditation results and performance measurement reports to help them evaluate the quality of healthcare and service
* 2. Because of employers’ concern about the quality and costs of healthcare services available through health plans, direct contracting has become a dominant model among employers who sponsor health benefit programs for their employees

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

Correct Answer: D

Health plan performance measures include structure measures, process measures, and outcome measures. The following statements are about the characteristics of these three types ofperformance measures. Three of the statements are true and one is false. Select the answer choice containing the FALSE statement.

1. A. The most widely used structure measures relate to physician education and training.
2. B. One advantage of structure measures over process measures is that structures are often linked directly to healthcare outcomes.
3. C. Process measures are useful in identifying underuse, overuse, and inappropriate use of services.
4. D. One disadvantage of outcome measures is that they can be influenced by factors outside the control of the health plan.

Correct Answer: B