Evidence Based Care correct answers Helps us identify the most appropriate individualized
treatment plan, improves patient outcomes, increase effectiveness and efficiency of interventions,
and most current research and patient outcome measures
Empanelment correct answers The act of assigning individual patients to individual primary care
providers (PCP) and care teams with sensitivity to patient and family preference. The basis for
population health management and the key to continuity of care.
Strategic Partners Community Resources correct answers PCP. Outpatient clinics, Women's
Health. Specialty care providers, therapists, pharmaceutical support, social workers
Accountable Care Organization (ACO) correct answers Improve patient outcomes through
coordination of care measures and service that improve a patient's quality of life. Goal: reduce
hospital readmission and improve patient compliance in community settings.
AIMS Care Coordination Model (PACO like TACO) correct answers Patient Engagement
Assessment and Care plan Development
Case Management
Ongoing Care as Needed
Patient Engagement Phase PACO correct answers Interact
Ensure
Provide guidance and resources
Assessment and Care Plan Development Phase PACO correct answers Identify social and
environmental factors that may affect medical plan adherence, health care serves utilization, and
health care outcomes.
Collect information that is helpful
, Develop care plan
Case Management Phase PACO correct answers Patient stays on track and has the support
Monitoring goal progress
Modifying the care plan as necessary
Ongoing Care as Needed Phase PACO correct answers Ensuring that community-based resources
are in place
Contact the care coordinator should new challenges arise
Summarize achieved goals or negotiate continued work
Closing the case if appropriate
Value Based Healthcare correct answers Quality case as the leading driver. Quality over quantity
Scope of Practice correct answers a set of regulations and ethical considerations that define the
scope, or extent and limits, of the EMT's job
fee-for-service correct answers Health plan that repays the policyholder for covered medical
expenses
Diagnostic Related Groups (DRGs) correct answers Patient classification system to help control
and standardize costs for inpatient services. Used along with patient and regional demographic
data to determine the median cost for a particular procedure/service. Categorize patients into
groups based on -diagnoses, type of treatment (ex. surgical), complications or comorbidities, age,
gender, discharge status. Determine length of stay, average cost the hospital should charge for
similar patients.
Care Coordination Process correct answers 1. Client identification and selection
2. Assessment and problem/ Opportunity identification
3. Development of the case management plan