Ed.
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Chapter1:The Evolving Landscape of Collaborative
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Multiple
Choice
1. Which assessments of care providers are performed as part of the Value Based
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Purchasing initiative?
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Select all that apply. sr sr sr
a. Appraising costs per case ofcare for Medicare patients s r sr sr sr sr sr sr sr
b. Assessing patients’ satisfaction with hospital care s r s r s r s r sr
c. Evaluating available evidence to guide clinical care guidelines s r sr s r sr s r s r sr
d. Monitoring mortality rates ofall patients with pneumonia sr s r sr sr sr s r sr
e. Requiring advanced IT standards and minimum cash reserves s r sr sr sr sr s r sr
ANS: A, B, D s r sr sr
Value Based Purchasing looks at five domain areas of processes of care, including efficiency of
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care (cost per case), experience of care (patient satisfaction measures), and outcomes of care
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(mortality rates for certain conditions. Evaluation of evidence to guide clinical care is part of
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evidence-based practice. The requirements for IT standards and financial status are part of
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Accountable Care Organization standards. REF: Value Based Purchasing
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2. What was an important finding of the Advisory Board survey of 2014 about
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primary care preferences of patients?
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a. Associations with areahospitals s r sr sr
b. Costs ofambulatory care sr sr s r
c. Ease of access to care sr sr sr sr
d. The ratio ofproviders to patients
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ANS: C s r
As part of the 2014 survey, the Advisory Board learned that patients desired 24/7 access to care,
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walk-in settings and the ability to be seen within 30 minutes, and care that is close to home.
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Associations with hospitals, costs of care, and the ratio of providers to patients were not part of
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these results. REF: The New Look of Primary Care
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3. A small, rural hospital is part of an Accountable Care Organization (ACO) and is designated
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as a Level 1 ACO. What is part of this designation?
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a. Bonuses based on achievement ofbenchmarks sr sr sr s r sr
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b. Care coordination for chronic diseases
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c. Standards for minimum cash reserves sr sr s r sr
d. Strict requirements for financial reporting
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ANS: A s r
A Level 1 ACO has the least amount of financial risk and requirements, but receives shared
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savings bonuses based on achievement of benchmarks for quality measures and expenditures.
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Care coordination and minimum cash reserves standards are part of Level 2 ACO requirements.
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Level 3 ACOs have strict requirements for financial reporting. REF: Accountable Care
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Organizations
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, Buttaro: Primary Care, A s r sr s r Collaborative Practice, 5th sr sr
Ed.
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Chapter 2:Transitional Care
Test Bank sr
Multiple
Choice
1. To reduce adverse events associated with care transitions, the Centers for
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Medicare and Medicaid Service have implemented which policy?
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a. Mandates for communication among primary caregivers and hospitalists
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b. Penalties for failure to perform medication reconciliations attime ofdischarge
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c. Reduction ofpayments for patients readmitted within 30 days after discharge
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d. Requirements for written discharge instructions for patients and caregivers s r sr sr s r s r sr s r sr
ANS: C s r
As a component of the Affordable Care Act, the Centers for Medicare and Medicaid Service
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developed the Readmissions Reduction Program reducing payments for certain patients
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readmitted within 30 days of discharge. The CMS did not mandate communication, institute
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penalties for failure to perform medication reconciliations, or require written discharge
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instructions. REF: Transitional Care
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2. According to Naylor’s transitional care model, which intervention has resulted in lower
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costs and fewer rehospitalizations in high-risk older patients?
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a. Coordination of post-hospital care byadvanced practice nurses s r sr s r sr rs s r s r
b. Frequent post-hospital clinic visits with a primary care provider
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c. Inclusion ofextended family members in the outpatient plan ofcare
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d. Telephone follow up bythe pharmacist to assess medication compliance sr s r sr sr sr s r sr sr s r
ANS: A s r
Naylor’s transitional care model provided evidence that high risk older patients who had post-
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hospital care coordinated by an APN had reduced rehospitalization rates. It did not include clinic
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visits with a primary care provider, inclusion of extended family members in the plan of care, or
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telephone follow up by a pharmacist. REF: Transitional Care
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3. Which approaches are among those recommended by the Agency for Healthcare
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Research and Quality to improve health literacy in patients?
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Select all that apply. sr sr sr
a. Empowering patients and families s r sr sr
b. Giving written handouts for all teaching s r sr s r sr sr