Page 1 of 65
Population Health Improvement Plan |
2026 Update with complete solutions
a) Reduce costs, improve population health, enhance patient
experience
b) Increase revenue, reduce readmissions, hire more staff
c) Maximize fee-for-service, reduce documentation, improve
technology
d) Focus only on quality measures
Answer: a) Reduce costs, improve population health, enhance
patient experience
Rationale: The IHI Triple Aim (Berwick et al.) adds a fourth aim –
clinician well-being – but original three are cost, population health,
and experience. VBC aligns with this framework.
2. Value in healthcare is defined as:
a) Outcome per dollar (Quality / Cost)
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b) Number of procedures performed
c) Patient satisfaction score alone
d) Total revenue generated
Answer: a) Outcome per dollar (Quality / Cost)
Rationale: Michael Porter’s definition: value = outcomes / cost.
VBC rewards better outcomes at lower cost, not volume.
3. Which payment model pays a fixed amount per patient per
month (PMPM) for a defined set of services, regardless of
utilization?
a) Bundled payment
b) Capitation
c) Fee-for-service
d) Pay-for-performance
Answer: b) Capitation
Rationale: Capitation is a prospective payment where providers
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receive a fixed PMPM fee. This incentivizes efficiency but risks
under-service. Risk-adjusted capitation reduces selection bias.
4. An Accountable Care Organization (ACO) is a group of
providers who:
a) Share financial and medical responsibility for a defined
patient population, with shared savings/risk
b) Bill separately for each service
c) Only accept cash payments
d) Are not accountable for quality
Answer: a) Shared responsibility and shared savings
Rationale: ACOs are networks that coordinate care for Medicare
(or commercial) patients. If they reduce costs while meeting quality
thresholds, they share in savings (or risk losses in downside risk
models).
5. The Medicare Shared Savings Program (MSSP) has
transitioned in 2024-2026 to require:
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a) All ACOs to accept two-sided risk (downside) by year 3
b) Only upside risk allowed
c) No quality reporting
d) Mandatory electronic health records only
Answer: a) Two-sided risk
Rationale: CMS has phased in requirements for ACOs to assume
downside risk (repaying losses) after a period of upside-only. This
increases accountability.
6. Bundled payments (e.g., CJR, BPCI) pay:
a) A single episode-based payment covering all services for a
defined condition (e.g., hip replacement)
b) Per diem rates
c) Separate payments for each provider
d) Global capitation for all patients
Answer: a) Single payment for episode
*Rationale: Bundled payments cover hospital, physician, post-
Population Health Improvement Plan |
2026 Update with complete solutions
a) Reduce costs, improve population health, enhance patient
experience
b) Increase revenue, reduce readmissions, hire more staff
c) Maximize fee-for-service, reduce documentation, improve
technology
d) Focus only on quality measures
Answer: a) Reduce costs, improve population health, enhance
patient experience
Rationale: The IHI Triple Aim (Berwick et al.) adds a fourth aim –
clinician well-being – but original three are cost, population health,
and experience. VBC aligns with this framework.
2. Value in healthcare is defined as:
a) Outcome per dollar (Quality / Cost)
,Page 2 of 65
b) Number of procedures performed
c) Patient satisfaction score alone
d) Total revenue generated
Answer: a) Outcome per dollar (Quality / Cost)
Rationale: Michael Porter’s definition: value = outcomes / cost.
VBC rewards better outcomes at lower cost, not volume.
3. Which payment model pays a fixed amount per patient per
month (PMPM) for a defined set of services, regardless of
utilization?
a) Bundled payment
b) Capitation
c) Fee-for-service
d) Pay-for-performance
Answer: b) Capitation
Rationale: Capitation is a prospective payment where providers
,Page 3 of 65
receive a fixed PMPM fee. This incentivizes efficiency but risks
under-service. Risk-adjusted capitation reduces selection bias.
4. An Accountable Care Organization (ACO) is a group of
providers who:
a) Share financial and medical responsibility for a defined
patient population, with shared savings/risk
b) Bill separately for each service
c) Only accept cash payments
d) Are not accountable for quality
Answer: a) Shared responsibility and shared savings
Rationale: ACOs are networks that coordinate care for Medicare
(or commercial) patients. If they reduce costs while meeting quality
thresholds, they share in savings (or risk losses in downside risk
models).
5. The Medicare Shared Savings Program (MSSP) has
transitioned in 2024-2026 to require:
, Page 4 of 65
a) All ACOs to accept two-sided risk (downside) by year 3
b) Only upside risk allowed
c) No quality reporting
d) Mandatory electronic health records only
Answer: a) Two-sided risk
Rationale: CMS has phased in requirements for ACOs to assume
downside risk (repaying losses) after a period of upside-only. This
increases accountability.
6. Bundled payments (e.g., CJR, BPCI) pay:
a) A single episode-based payment covering all services for a
defined condition (e.g., hip replacement)
b) Per diem rates
c) Separate payments for each provider
d) Global capitation for all patients
Answer: a) Single payment for episode
*Rationale: Bundled payments cover hospital, physician, post-
