HCQM EXAMS BUNDLE with Questions and 100% Correct Verified Answers

Re-Engineered Hospital Discharge Intervention (Project RED) - Answer Led by Brian Jack - utilization of nurse discharge advocates who collaborate with the patient/caregivers to assess, plan and develop a coordinate approach for transition to the next level of care. Includes a post discharge conve...

Statistical Control Charts - Answer Run charts (line graphs) upon which upper and lower standard deviation lines are drawn. Used to differentiate special cause events from common cause events as those with a special cause origin will usually occur outside the upper and lower standard deviations l...

To Error is Human found out this about adverse events resulting from medical errors - Answer More than half could have been prevented. Number of Americans dying annually from medical errors - Answer 44,000-98,000 Medical care seems to have resisted safety improvement efforts, but it is difficult ...

Accountable Care Organizations exception - Answer Exempt when participating in a Medicare Shared Savings Program or when making distributions of shared savings it earned through the MSSP to participants in the ACO and for limited patient inducements for remuneration given to ACO beneficiaries. S...

Medicaid Integrity Program - Answer Established in 2005 by the Deficit Reduction Act. Used funding to contract with Program Safeguard Contractors who perform data analysis, develop fraud cases, support law enforcement and assist CMS in imposing administrative actions based on payment types within...

The percentage of unplanned returns to the operating room would be collected to measure procedure performance and patient monitoring. This would be an example of? - Answer outcome measure The final results of care, treatment, and services concerning a patient are included in what area of perform...

Comprehensive error rate testing CERT - Answer randomly selects a statistically-valid sample of Medicare FFS claims and reviews those claims and related medical records for compliance with Medicare coverage, payment, coding, and billing rules. Used to ID high- risk areas. Refers errors to MAC. Mo...

4 elements dictating scope of case management model - Answer 1. Care setting 2. Health conditions and needs of population served 3. Reimbursement methods 4. Health Care Discipline of the case manager 14 groups commonly targeted for case management - Answer 1. High medical costs/ER use/admissions...