CDEO Chapter 8 Questions With Complete Solutions
91 HEDIS MEASURES Correct Answers 1. Effectiveness of
Care
2. Access/Availability of Care
3. Experience of Care
4. Utilization and Relative Resource Use
5. Health Plan Descriptive Information
Measures are added, deleted, and revised annually.
ACI Measures Examples Correct Answers 1. e-Prescribing- At
least one permissible prescription written by the MIPS eligible
clinician is queried for a drug formulary and transmitted
electronically using certified EHR technology
2. Provide Patient Access - For at leas one unique patient seen
by the MIPS eligible clinician: 1) The patient is provided timely
access to view online, download, and transmit his or her health
information: and 2) the MIPS eligible clinical ensures the
patient's health information is available for the patient to access
using any application of their choice that is configured to meet
the technical specification of the Application Programming
Interface API in the MIPS eligible clinician's certified EHR
technology.
3. Patient- Specific Education - The MIPS eligible clinician
must use clinically relevant information from certified resources
and provide electronic access to those materials to at-least one
unique patient seen by the MIPS eligible clinician.
,Administrative Data Correct Answers are electronic records of
services, including insurance claims and registration systems
from hospitals, clinics, medical offices, pharmacies, and labs
Advanced Care Information Measures Correct Answers In
2017 providers have two options based on the provider's
electronic health record edition.
Option 1: Advancing Care Information Objectives and Measures
Option 2: 2017 Advancing Care Information Transition
Objective and Measures
Chart Reviews Correct Answers Analysis of the information
identified is used to target retrospective reviews to capture any
unreported diagnoses
Clinical Improvement Activities Examples: Correct Answers
1.) Care Transition Documentation Practice Improvements -
Implementation of practices/processes for acre transition that
include documentation of how a MIPS eligible clinician or
group carried out a patient-centered action plan for first 30 days
following a discharge
2) Collection and Use of Patient Experience and Satisfaction
Data on Access - Collection of patient experience and
satisfaction data on access to care and development of an
improvement plan, such as outlining steps for improving
communications with patients to help understanding or urgent
access needs.
, 3. Engagement of New Medicaid Patients and Follow Up-
Seeing new and follow-up Medicaid patients in a timely manner,
including individuals dually eligible for Medicaid and Medicare.
Clinical Improvement Activities Measures Correct Answers
Total of 92 activities in this category.
Most providers will attest to completing 4 improvement
activities. Provider groups of less than 15 participants or in a
rural of health shortage area will complete 2 activities.
CMS Demonstration Period Correct Answers Beginning in
2012, CMS conducted a nationwide 3 year demonstration
project where by a scaled bonus program was used, with the
expectation that Medicare Advantage organizations with three or
more stars would push themselves toward earning four and five
star ratings. During this period, plans that were at or above three
stars would receive quality bonus payments based on a sliding
scale.
CMS Stars Ratings Correct Answers
Collecting HEDIS Correct Answers an incentive for many
health plans to collect HEDIS data is a CMS requirement that
health maintenance organizations submit Medicare HEDIS data
to provide HMO services for Medicare enrollees under a
program called Medicare Advantage
E-prescribing electronically transmits new and refill
prescriptions to a community or mail order pharmacy. What is
an advantage to E-Prescribing (eRx)? Correct Answers The
91 HEDIS MEASURES Correct Answers 1. Effectiveness of
Care
2. Access/Availability of Care
3. Experience of Care
4. Utilization and Relative Resource Use
5. Health Plan Descriptive Information
Measures are added, deleted, and revised annually.
ACI Measures Examples Correct Answers 1. e-Prescribing- At
least one permissible prescription written by the MIPS eligible
clinician is queried for a drug formulary and transmitted
electronically using certified EHR technology
2. Provide Patient Access - For at leas one unique patient seen
by the MIPS eligible clinician: 1) The patient is provided timely
access to view online, download, and transmit his or her health
information: and 2) the MIPS eligible clinical ensures the
patient's health information is available for the patient to access
using any application of their choice that is configured to meet
the technical specification of the Application Programming
Interface API in the MIPS eligible clinician's certified EHR
technology.
3. Patient- Specific Education - The MIPS eligible clinician
must use clinically relevant information from certified resources
and provide electronic access to those materials to at-least one
unique patient seen by the MIPS eligible clinician.
,Administrative Data Correct Answers are electronic records of
services, including insurance claims and registration systems
from hospitals, clinics, medical offices, pharmacies, and labs
Advanced Care Information Measures Correct Answers In
2017 providers have two options based on the provider's
electronic health record edition.
Option 1: Advancing Care Information Objectives and Measures
Option 2: 2017 Advancing Care Information Transition
Objective and Measures
Chart Reviews Correct Answers Analysis of the information
identified is used to target retrospective reviews to capture any
unreported diagnoses
Clinical Improvement Activities Examples: Correct Answers
1.) Care Transition Documentation Practice Improvements -
Implementation of practices/processes for acre transition that
include documentation of how a MIPS eligible clinician or
group carried out a patient-centered action plan for first 30 days
following a discharge
2) Collection and Use of Patient Experience and Satisfaction
Data on Access - Collection of patient experience and
satisfaction data on access to care and development of an
improvement plan, such as outlining steps for improving
communications with patients to help understanding or urgent
access needs.
, 3. Engagement of New Medicaid Patients and Follow Up-
Seeing new and follow-up Medicaid patients in a timely manner,
including individuals dually eligible for Medicaid and Medicare.
Clinical Improvement Activities Measures Correct Answers
Total of 92 activities in this category.
Most providers will attest to completing 4 improvement
activities. Provider groups of less than 15 participants or in a
rural of health shortage area will complete 2 activities.
CMS Demonstration Period Correct Answers Beginning in
2012, CMS conducted a nationwide 3 year demonstration
project where by a scaled bonus program was used, with the
expectation that Medicare Advantage organizations with three or
more stars would push themselves toward earning four and five
star ratings. During this period, plans that were at or above three
stars would receive quality bonus payments based on a sliding
scale.
CMS Stars Ratings Correct Answers
Collecting HEDIS Correct Answers an incentive for many
health plans to collect HEDIS data is a CMS requirement that
health maintenance organizations submit Medicare HEDIS data
to provide HMO services for Medicare enrollees under a
program called Medicare Advantage
E-prescribing electronically transmits new and refill
prescriptions to a community or mail order pharmacy. What is
an advantage to E-Prescribing (eRx)? Correct Answers The
