1. A small, rural hospital is part of an Accountable Care
Organization (ACO) and is designated as a Level 1 ACO. What is
part of this designation?
a. Bonuses based on achievement of benchmarks
b. Care coordination for chronic diseases
c. Standards for minimum cash reserves
d. Strict requirements for financial reporting - correct answer ANS: A
A Level 1 ACO has the least amount of financial risk and
requirements, but receives shared
savings bonuses based on achievement of benchmarks for
quality measures and
,expenditures. Care coordination and minimum cash reserves
standards are part of Level 2 ACO requirements. Level 3 ACOs
require financial reporting
2. What was an important finding of the Advisory Board survey
of 2014 about primary care preferences of patients?
a. Associations with area hospitals
b. Costs of ambulatory care
c. Ease of access to care
d. The ratio of providers to patients - correct answer ANS: C
As part of the 2014 survey, the Advisory Board learned that
patients desired 24/7 access to care, walk-in settings and the
ability to be seen within 30 minutes, and care that is close to
home. Associations with hospitals, costs of care, and the ratio
of providers to patients were not part of these results.
3. Which statement made by a health care provider
demonstrates the most appropriate understanding for the goal
of a performance report?
,a. "This process allows me to critique the performance of the
rest of the staff." b. "Most organizations require staff to undergo
a performance evaluation yearly."
c. "It is hard to be personally criticized but that's how we learn
to change."
d. "The comments should help me improve my management
skills." - correct answer ANS: D
The goal of the performance report is to provide guidance to
staff in the areas of professional development, mentoring, and
leadership development. A peer review is written by others who
perform similar skills (peers). The remaining options may be
true but do not provide evidence of understanding of the goal
of this professional requirement.
4. Which assessment question would a health care provider ask
when engaging in the previsit stage of the new model for
primary care? (Select all that apply.)
a. "Are you ready to discuss some of the community resources
that are available?"
b. "Are you experiencing any side effects from your newly
prescribed medications?"
, c. "Do you anticipate any problems with adhering to your
treatment plan?"
d. "Are you ready to discuss the results of your laboratory
tests?"
e. "Do you have any questions about the lab tests that have
been ordered for you?" - correct answer ANS: B, C, E
The nursing responsibilities in the previsit stage include
assessing the patient's tolerance of prescribed medications,
understanding of existing treatment plan, and education about
required lab testing. The primary care provider is responsible
for screening lab data and discussing community resources
during the actual visit.
5. To reduce adverse events associated with care transitions,
the Centers for Medicare and Medicaid Service have
implemented which policy?
a. Mandates for communication among primary caregivers and
hospitalists
b. Penalties for failure to perform medication reconciliations at
time of discharge
c. Reduction of payments for patients readmitted within 30 days
after discharge