Ncqa uses what model Study guides, Class notes & Summaries

Risk Adjustment (a prospective payment system) - correct answer The process of increasing or reducing payments to health plans to reflect higher or lower than expected spending. Risk adjusting is designed to compensate health plans that enroll an older and sicker population as a way to discourage plans from selecting only healthier enrollees. What is the goal when coding for risk adjustment? - correct answer code ALL current dx What is the purpose of collecting dx in risk adjustment coding...

PCMH CCE Exam Prep - Questions and Answers What is considered a multi-site? A practice with more than one site What are the endorsed principles of PCMH and how do they relate to practices being able to deliver high quality care. Comprehensive and coordinated care with a patient-centered approach to ensure access, safety and quality. Explain the efficacy of evidence based guidelines. Evidence based guidelines are reputable frameworks that have been proven in the market. What is the overview sec...

Risk Adjustment (a prospective payment system) The process of increasing or reducing payments to health plans to reflect higher or lower than expected spending. Risk adjusting is designed to compensate health plans that enroll an older and sicker population as a way to discourage plans from selecting only healthier enrollees. What is the goal when coding for risk adjustment? code ALL current dx What is the purpose of collecting dx in risk adjustment coding? Adjust potential ri...

WGU C215 Q Bank For CPHQ Practice Questions And Answers A healthcare quality management professional has all of the following responsibilities toward improving patient safety EXCEPT: 1) Appointing a supervisor for a patient safety program 2) Incorporating new technology into a patient safety program 3) Helping to develop a patient safety program 4) Setting and reviewing goals for a patient safety program Correct Ans - 1) Appointing a supervisor for a patient safety program In terms o...

PCMH CCE EXAM (PCMH CCE EXAM PREP) 2024 QUIZZES & ANS!!

CPHQ 2023 Update- Section 2 What is Quality Review and Accountability? (QRA) - ANS-Data Acquisition, Data integrity, analysis, modeling, benchmarking + communication, collaboration, partnership, behavior change = increased transparency and improvement Value-Based Reimbursement Models - ANS-reward high quality and lower cost through financial incentives and shared savings that can boost an organizations operating margin. (principles: shared risk, improved public health, lowered cost) M...

RHIA AHIMA practice Test 108 Questions with Verified Answers Processing - CORRECT ANSWER Domain 2 Classifying, sorting, storing and retrieving data are all characteristics of which system component? 1. Output 2. Feedback 3.Processing 4.Input K81.2, OFT40ZZ, OFJ44ZZ - CORRECT ANSWER Domain 1 The patient is taken to the OR for a laparoscopic gallbladder removal secondary to acute and chronic cholecystitis. The surgeon encounters difficulty secondary to the patients body habitus and co...

According to the RAND Health Insurance Experiment, which variable has the greatest power in explaining health expenditures? A.) Welfare eligibility B.) Prior utilization C.) Physical health (based on self-reported measures) D.) General health (based on self-reported measures) E.) Mental health (based on self-reported measures) B.) Prior utilization A provision in some group life insurance plans that provides for the payment of all or part of the death benefit in the event of the i...

Nursing Informatics Exam 229 Questions with Verified Answers Information theory - CORRECT ANSWER Processing data to produce information and, in combination with knowledge and wisdom, using information to provide care Change Theory - CORRECT ANSWER unfreezing -->moving-->refreezing Systems Theory - CORRECT ANSWER interaction among parts Behaviorism - CORRECT ANSWER desired behaviors are reinforced Constructivism - CORRECT ANSWER reinterpret the world to fit new situations ...

RHIA Exam Prep 101 Questions with Verified Answers HL7 - CORRECT ANSWER A set of international standards for transfer of clinical and administrative data between software applications used by various healthcare providers. These standards focus on the application layer, which is "layer 7" in the OSI model. Data Validity - CORRECT ANSWER Accuracy of data Data Comprehensiveness - CORRECT ANSWER All data items are included. Data Granularity - CORRECT ANSWER (a) The attributes and value...