HAPP 452 Exam Questions With
Complete Solutions
Value based purchasing - ANSWER (VBP) is a Centers for Medicare & Medicaid (CMS)
program that rewards hospitals with financial incentives for quality care provided to
Medicare and Medicaid beneficiaries
Incentivized Payment System
Payment system based on quality and efficiency of care, not patient volume
Why VBP - ANSWER it provides bonuses to hospitals that meet performance standards
imporves patient health outcomes, reduces costs, and increases hosptial responsibility
for quality healthcare delivery
Ensure Quality + Reduce Cost - ANSWER = Overall Savings
VBP can only - ANSWER improve quality in areas that it measures and for which it
provides incentives
The Five Essentials of the VBP Approach - ANSWER Patient-Centered Approach
Aligned Incentives
Selection of Metrics
Continuous Support from CMS
All Hands on Deck
Gainsharing - ANSWER an arrangement between a hospital and physicians under which
the hospital proposes to pay the physicians a share of any reductions in the hospital's
costs that are attributable in part to the physician's' efforts
Gain sharing reduces cost by - ANSWER Waste reduction
Product standardization and substitution
Quality improvement
Hospital Readmissions Reduction - ANSWER Punishes hospitals that incur a certain
amount of readmissions
Judged on readmission rates for heart failure, acute myocardial infarction, and
pneumonia
,Hospitals with higher percentage of patients on Medicare and Medicaid may suffer
Some hospitals have avoided this fate by creating programs to keep track of patients
Accountable Care Organization - ANSWER group of health care providers who accept
shared accountability for the cost and quality of care delivered to a population of
patients
ACO payment systems - ANSWER One-sided - ACO would share the savings with
Medicare, but not in the losses
Two-sided - ACO gains more savings, but assumes risk by participating in the losses
advantages of VBP/PFP - ANSWER Reduction in resource use
Limiting overutilization of services
Longer continuum of care management
Increased standardized data and quality metrics
Assessment of social factors
Maximization of patient outcomes
Increased competition of HSO's
disadvantages of VBP/PFP - ANSWER Unforeseen risks
Revenue losses
Implementation costs
Administration and teaching
Organization reputation
Internal and external
Inaccuracy/relative quality metrics
New legislation
HealthChoice's 5 Key Princip - ANSWER Guarantee access to medical homes for all
enrollees
Provide and improve preventative care services
Build on the strengths of the existing health care system
Enhance the plans' and providers' accountability for high quality care
Obtain better value for state expenditures
, HealthChoice's Use of VBP to MC - ANSWER VBP performance measures determine the
financial incentive or disincentive to HealthChoice MCOs
The financial incentive is up to 1/13 of 1% of the total capitation payment made to the
MCO that year (the disincentive penalty is the same) (Delmarva Foundation, 2016, p. 11)
10 performance measures determined by the MD Department of Health and MCOs
Adolescent Well Care
Adult BMI Assessment
Postpartum Care
Active Euthanasia - ANSWER the act of intentionally taking another person's life in order
to ease their pain and suffering. Lethal injections are the most common form associated
with this practice
Passive Euthanasia - ANSWER more recently has been referred to as "forgoing
life-sustaining treatment
Voluntary - ANSWER : euthanasia performed at the patient's request
Non-Voluntary - ANSWER : euthanasia performed on the consent of a patient's durable
power of attorney.
Involuntary: - ANSWER euthanasia performed without having the expressed request of
the patient
Advanced Directives - ANSWER legal documents that provide instructions about future
medical care requested by the patient if and when they are unable to participate in
making medical decision. Either when the patient is unable to communicate, or is not
competent due to their condition worsening.
Durable Power of Attorney - ANSWER advanced directive that is used when the patient
is no longer competent enough to continue making medical decisions. This gives a
specified person the authority to make medical decisions on the patient's behalf
Living Will - ANSWER a type of advanced directive, used when the patient is unable to
communicate, that provides instructions about future medical care.
Palliative Care - ANSWER associated with continuum of care, hospice, and comfort
care; providing a patient, who is terminally-ill, with the resources to keep them as
comfortable as possible during their last stages of life.
Life-sustaining treatment - ANSWER any care, that if discontinued, would result in the
death of the patient.
Countries Where Assisted Suicide is Legal - ANSWER Belgium
Complete Solutions
Value based purchasing - ANSWER (VBP) is a Centers for Medicare & Medicaid (CMS)
program that rewards hospitals with financial incentives for quality care provided to
Medicare and Medicaid beneficiaries
Incentivized Payment System
Payment system based on quality and efficiency of care, not patient volume
Why VBP - ANSWER it provides bonuses to hospitals that meet performance standards
imporves patient health outcomes, reduces costs, and increases hosptial responsibility
for quality healthcare delivery
Ensure Quality + Reduce Cost - ANSWER = Overall Savings
VBP can only - ANSWER improve quality in areas that it measures and for which it
provides incentives
The Five Essentials of the VBP Approach - ANSWER Patient-Centered Approach
Aligned Incentives
Selection of Metrics
Continuous Support from CMS
All Hands on Deck
Gainsharing - ANSWER an arrangement between a hospital and physicians under which
the hospital proposes to pay the physicians a share of any reductions in the hospital's
costs that are attributable in part to the physician's' efforts
Gain sharing reduces cost by - ANSWER Waste reduction
Product standardization and substitution
Quality improvement
Hospital Readmissions Reduction - ANSWER Punishes hospitals that incur a certain
amount of readmissions
Judged on readmission rates for heart failure, acute myocardial infarction, and
pneumonia
,Hospitals with higher percentage of patients on Medicare and Medicaid may suffer
Some hospitals have avoided this fate by creating programs to keep track of patients
Accountable Care Organization - ANSWER group of health care providers who accept
shared accountability for the cost and quality of care delivered to a population of
patients
ACO payment systems - ANSWER One-sided - ACO would share the savings with
Medicare, but not in the losses
Two-sided - ACO gains more savings, but assumes risk by participating in the losses
advantages of VBP/PFP - ANSWER Reduction in resource use
Limiting overutilization of services
Longer continuum of care management
Increased standardized data and quality metrics
Assessment of social factors
Maximization of patient outcomes
Increased competition of HSO's
disadvantages of VBP/PFP - ANSWER Unforeseen risks
Revenue losses
Implementation costs
Administration and teaching
Organization reputation
Internal and external
Inaccuracy/relative quality metrics
New legislation
HealthChoice's 5 Key Princip - ANSWER Guarantee access to medical homes for all
enrollees
Provide and improve preventative care services
Build on the strengths of the existing health care system
Enhance the plans' and providers' accountability for high quality care
Obtain better value for state expenditures
, HealthChoice's Use of VBP to MC - ANSWER VBP performance measures determine the
financial incentive or disincentive to HealthChoice MCOs
The financial incentive is up to 1/13 of 1% of the total capitation payment made to the
MCO that year (the disincentive penalty is the same) (Delmarva Foundation, 2016, p. 11)
10 performance measures determined by the MD Department of Health and MCOs
Adolescent Well Care
Adult BMI Assessment
Postpartum Care
Active Euthanasia - ANSWER the act of intentionally taking another person's life in order
to ease their pain and suffering. Lethal injections are the most common form associated
with this practice
Passive Euthanasia - ANSWER more recently has been referred to as "forgoing
life-sustaining treatment
Voluntary - ANSWER : euthanasia performed at the patient's request
Non-Voluntary - ANSWER : euthanasia performed on the consent of a patient's durable
power of attorney.
Involuntary: - ANSWER euthanasia performed without having the expressed request of
the patient
Advanced Directives - ANSWER legal documents that provide instructions about future
medical care requested by the patient if and when they are unable to participate in
making medical decision. Either when the patient is unable to communicate, or is not
competent due to their condition worsening.
Durable Power of Attorney - ANSWER advanced directive that is used when the patient
is no longer competent enough to continue making medical decisions. This gives a
specified person the authority to make medical decisions on the patient's behalf
Living Will - ANSWER a type of advanced directive, used when the patient is unable to
communicate, that provides instructions about future medical care.
Palliative Care - ANSWER associated with continuum of care, hospice, and comfort
care; providing a patient, who is terminally-ill, with the resources to keep them as
comfortable as possible during their last stages of life.
Life-sustaining treatment - ANSWER any care, that if discontinued, would result in the
death of the patient.
Countries Where Assisted Suicide is Legal - ANSWER Belgium
