PAT Training - Example Questions to
Ask the Provider (UPDATED) with
Correct Answers8
Milestone #1 - Practice uses a consistent approach to assign patients to a provider panel and
confirms assignments with providers and patients. Practice reviews and updates panel
assignments on a regular basis. - ANSWERS-What happens to a providers panel when he/she
leaves the practice?
How do patients get reassigned to providers and how are panel sizes balanced with the level of
patient acuity?
Milestone #2 - Practice has a reliable process in place for identifying risk level of each patient
and providing care appropriate to the level of risk. This may include making accurate and
compliant risk adjustments when a patient develops a condition not already present,
exacerbation of a condition or complications, need for a higher intensity level of care, including
hospitalization. - ANSWERS-Tell me how you risk stratify patients and provide the appropriate
level of care to match the risk score.
Milestone #4 - Practice has a patient engagement workflow to engage both seen and unseen
patients. - ANSWERS-Tell me about the workflows that you have to identify and engage in
patients who have not been seen as well as those who are seen.
Milestone #3 - Practice uses HCC risk coding to understand the needs and cost of care for
patients. - ANSWERS-Does your practice use HCC risk coding to understand cost of care for
patients?
How does your practice promote coding to the highest level of specificity across all lines of
business?
, How is staff utilized to support high risk patients?
Milestone #5 - Practice follows up via phone, visit, or electronic means with patients within a
designated time interval (24 hours/ 48 hours/ 72 hours/ 7 days) after an emergency room visit
or hospital discharge. - ANSWERS-What protocols do you have for ED and inpatient discharge as
it relates to the follow-up time frame for patients and by what means are they contacted?
Milestone #9 - Practice clearly defines care coordination roles and responsibilities and these
have been fully implemented with the practice. - ANSWERS-To what extent does the practice
document roles and responsibilities to promote care coordination.
Milestone #17 - Practice uses population reports or registries to identify care gaps and acts to
reduce them. - ANSWERS-How do you obtain care gap reports and what structure exists to work
those care gap reports including workflows to outreach to patients?
Milestone #15 - Practice has a system in place for patients to speak with their care team 24/7
and access as needed - ANSWERS-Does the practice have a system in place for patients to speak
with their care team 24/7 and access as needed?
How do patients access clinical direction after hours?
Milestone #10 - Practice has developed a vision and plan for transformation that includes
specific clinical, patient experience and cost of care outcomes. - ANSWERS-Do you have a
transformation plan in place that includes clinical, patient experience, and cost of care
outcomes?
Tell me about your vision for implementing value based care.
Ask the Provider (UPDATED) with
Correct Answers8
Milestone #1 - Practice uses a consistent approach to assign patients to a provider panel and
confirms assignments with providers and patients. Practice reviews and updates panel
assignments on a regular basis. - ANSWERS-What happens to a providers panel when he/she
leaves the practice?
How do patients get reassigned to providers and how are panel sizes balanced with the level of
patient acuity?
Milestone #2 - Practice has a reliable process in place for identifying risk level of each patient
and providing care appropriate to the level of risk. This may include making accurate and
compliant risk adjustments when a patient develops a condition not already present,
exacerbation of a condition or complications, need for a higher intensity level of care, including
hospitalization. - ANSWERS-Tell me how you risk stratify patients and provide the appropriate
level of care to match the risk score.
Milestone #4 - Practice has a patient engagement workflow to engage both seen and unseen
patients. - ANSWERS-Tell me about the workflows that you have to identify and engage in
patients who have not been seen as well as those who are seen.
Milestone #3 - Practice uses HCC risk coding to understand the needs and cost of care for
patients. - ANSWERS-Does your practice use HCC risk coding to understand cost of care for
patients?
How does your practice promote coding to the highest level of specificity across all lines of
business?
, How is staff utilized to support high risk patients?
Milestone #5 - Practice follows up via phone, visit, or electronic means with patients within a
designated time interval (24 hours/ 48 hours/ 72 hours/ 7 days) after an emergency room visit
or hospital discharge. - ANSWERS-What protocols do you have for ED and inpatient discharge as
it relates to the follow-up time frame for patients and by what means are they contacted?
Milestone #9 - Practice clearly defines care coordination roles and responsibilities and these
have been fully implemented with the practice. - ANSWERS-To what extent does the practice
document roles and responsibilities to promote care coordination.
Milestone #17 - Practice uses population reports or registries to identify care gaps and acts to
reduce them. - ANSWERS-How do you obtain care gap reports and what structure exists to work
those care gap reports including workflows to outreach to patients?
Milestone #15 - Practice has a system in place for patients to speak with their care team 24/7
and access as needed - ANSWERS-Does the practice have a system in place for patients to speak
with their care team 24/7 and access as needed?
How do patients access clinical direction after hours?
Milestone #10 - Practice has developed a vision and plan for transformation that includes
specific clinical, patient experience and cost of care outcomes. - ANSWERS-Do you have a
transformation plan in place that includes clinical, patient experience, and cost of care
outcomes?
Tell me about your vision for implementing value based care.
