,Buttaro:x PrimaryxCare,x Ax Collaborativex Practice,x5thx Ed.
Chapterx1:xThexEvolvingxLandscapexofxCollaborativexPracticexTes
txBank
MultiplexChoice
1. WhichxassessmentsxofxcarexprovidersxarexperformedxasxpartxofxthexValuexBasedxPurchasingxiniti
ative?
Selectxallxthatxapply.
a. AppraisingxcostsxperxcasexofxcarexforxMedicarexpatientsxb.x
Assessingx patients’x satisfactionx withx hospitalx care
c.x Evaluatingx availablex evidencex toxguidex clinicalx carexguidelinesxd
.x Monitoringx mortalityx ratesxofxallx patientsxwithxpneumonia
e.x Requiringx advancedxITxstandardsx andxminimumx cashxreserves
ANS:x A,x B,xD
ValuexBasedxPurchasingxlooksxatxfivexdomainxareasxofxprocessesxofxcare,xincludingxefficiencyxofxcar
ex(costxperxcase),xexperiencexofxcarex(patientxsatisfactionxmeasures),xandxoutcomesxofxcarex(mortalit
yxratesxforxcertainxconditions.xEvaluationxofxevidencextoxguidexclinicalxcarexisxpartxofxevidence-
basedxpractice.xThexrequirementsxforxITxstandardsxandxfinancialxstatusxarexpartxofxAccountablex Carex
Organizationxstandards.xREF:x Valuex Basedx Purchasing
2. Whatx wasx anx importantxfindingxofxthex Advisoryx Boardx surveyx ofx2014x aboutx primaryx carexpr
eferencesx ofxpatients?
a. Associationsx withx areaxhospitals
b. Costsxofxambulatoryxcarexc
.xEasex ofxaccessxtox care
d.x Thex ratiox ofxprovidersx toxpatients
ANS:x C
Asxpartxofxthex2014xsurvey,xthexAdvisoryxBoardxlearnedxthatxpatientsxdesiredx24/7xaccessxtoxcare,xw
alk-
inxsettingsxandxthexabilityxtoxbexseenxwithinx30xminutes,xandxcarexthatxisxclosextoxhome.xAssociationsx
withxhospitals,xcostsxofxcare,xandxthexratioxofxprovidersxtoxpatientsxwerexnotxpartxofxthesex results.x R
EF:x Thex NewxLookx ofx Primaryx Care
3. Axsmall,x ruralx hospitalx isx partxofxanxAccountablex Carex Organizationx (ACO)xandx isx designatedxasx
axLevelx 1xACO.xWhatx isx partx ofxthisx designation?
a. Bonusesx basedxonxachievementxofxbenchmarks
,TestxBank 2
b. Carexcoordinationx forx chronicx diseases
c. Standardsxforxminimumxcashxreserves
d. Strictxrequirementsx forxfinancialx reporting
ANS:x A
AxLevelx1xACOxhasxthexleastxamountxofxfinancialxriskxandxrequirements,xbutxreceivesxsharedxsaving
sxbonusesxbasedxonxachievementxofxbenchmarksxforxqualityxmeasuresxandxexpenditures.xCarexcoord
inationxandxminimumxcashxreservesxstandardsxarexpartxofxLevelx2xACOxrequirements.xLevelx3xACO
sxhavexstrictxrequirementsxforxfinancialxreporting.xREF:xAccountablexCarexOrganizations
, Buttaro:x PrimaryxCare,x Ax Collaborativex Practice,x5thx Ed.
Chapterx 2:xTransitionalx Carex
TestxBank
MultiplexChoice
1. Toxreducexadversexeventsxassociatedxwithxcarextransitions,xthexCentersxforxMedicarexandxMedic
aidx Servicex haveximplementedx whichx policy?
a. Mandatesxforxcommunicationx amongx primaryx caregiversx andxhospitalists
b. Penaltiesx forx failurex toxperformxmedicationx reconciliationsx atxtimex ofxdischargexc.
x Reductionxofxpaymentsx forx patientsx readmittedx withinx 30xdaysx afterx discharge
d.x Requirementsx forxwrittenx dischargex instructionsx forxpatientsx andxcaregivers
ANS:x C
AsxaxcomponentxofxthexAffordablexCarexAct,xthexCentersxforxMedicarexandxMedicaidxServicexdevel
opedxthexReadmissionsxReductionxProgramxreducingxpaymentsxforxcertainxpatientsxreadmittedxwith
inx30xdaysxofxdischarge.xThexCMSxdidxnotxmandatexcommunication,xinstitutexpenaltiesxforxfailurexto
xperformxmedicationxreconciliations,xorxrequirexwrittenxdischargexinstructions.x REF:x Transitionalx
Care
2. AccordingxtoxNaylor’sxtransitionalx carexmodel,x whichx interventionx hasx resultedx inxlowerxcostsxa
ndx fewerx rehospitalizationsxinx high-riskx olderx patients?
a. Coordinationx ofxpost-hospitalx carexbyxadvancedx practicex nurses
b. Frequentx post-hospitalx clinicx visitsx withx axprimaryx carexprovider
c. Inclusionx ofxextendedx familyx membersx inxxthex outpatientx planx ofxcare
d. Telephonex followx upxbyxthex pharmacistx tox assessxmedicationx compliance
ANS:x A
Naylor’sxtransitionalxcarexmodelxprovidedxevidencexthatxhighxriskxolderxpatientsxwhoxhadxpost-
xhospitalxcarexcoordinatedxbyxanxAPNxhadxreducedxrehospitalizationxrates.xItxdidxnotxincludexclinicxv
isitsxwithxaxprimaryxcarexprovider,xinclusionxofxextendedxfamilyxmembersxinxthexplanxofxcare,xorxtele
phonexfollowx upx byxaxpharmacist.x REF:x Transitionalx Care
3. WhichxapproachesxarexamongxthosexrecommendedxbyxthexAgencyxforxHealthcarexResearchxand
x Qualityx tox improvex healthx literacyx inx patients?
Selectxallxthatxapply.
a. Empoweringx patientsxandxfamilies
b. Givingx writtenx handoutsx forxallxteaching
Chapterx1:xThexEvolvingxLandscapexofxCollaborativexPracticexTes
txBank
MultiplexChoice
1. WhichxassessmentsxofxcarexprovidersxarexperformedxasxpartxofxthexValuexBasedxPurchasingxiniti
ative?
Selectxallxthatxapply.
a. AppraisingxcostsxperxcasexofxcarexforxMedicarexpatientsxb.x
Assessingx patients’x satisfactionx withx hospitalx care
c.x Evaluatingx availablex evidencex toxguidex clinicalx carexguidelinesxd
.x Monitoringx mortalityx ratesxofxallx patientsxwithxpneumonia
e.x Requiringx advancedxITxstandardsx andxminimumx cashxreserves
ANS:x A,x B,xD
ValuexBasedxPurchasingxlooksxatxfivexdomainxareasxofxprocessesxofxcare,xincludingxefficiencyxofxcar
ex(costxperxcase),xexperiencexofxcarex(patientxsatisfactionxmeasures),xandxoutcomesxofxcarex(mortalit
yxratesxforxcertainxconditions.xEvaluationxofxevidencextoxguidexclinicalxcarexisxpartxofxevidence-
basedxpractice.xThexrequirementsxforxITxstandardsxandxfinancialxstatusxarexpartxofxAccountablex Carex
Organizationxstandards.xREF:x Valuex Basedx Purchasing
2. Whatx wasx anx importantxfindingxofxthex Advisoryx Boardx surveyx ofx2014x aboutx primaryx carexpr
eferencesx ofxpatients?
a. Associationsx withx areaxhospitals
b. Costsxofxambulatoryxcarexc
.xEasex ofxaccessxtox care
d.x Thex ratiox ofxprovidersx toxpatients
ANS:x C
Asxpartxofxthex2014xsurvey,xthexAdvisoryxBoardxlearnedxthatxpatientsxdesiredx24/7xaccessxtoxcare,xw
alk-
inxsettingsxandxthexabilityxtoxbexseenxwithinx30xminutes,xandxcarexthatxisxclosextoxhome.xAssociationsx
withxhospitals,xcostsxofxcare,xandxthexratioxofxprovidersxtoxpatientsxwerexnotxpartxofxthesex results.x R
EF:x Thex NewxLookx ofx Primaryx Care
3. Axsmall,x ruralx hospitalx isx partxofxanxAccountablex Carex Organizationx (ACO)xandx isx designatedxasx
axLevelx 1xACO.xWhatx isx partx ofxthisx designation?
a. Bonusesx basedxonxachievementxofxbenchmarks
,TestxBank 2
b. Carexcoordinationx forx chronicx diseases
c. Standardsxforxminimumxcashxreserves
d. Strictxrequirementsx forxfinancialx reporting
ANS:x A
AxLevelx1xACOxhasxthexleastxamountxofxfinancialxriskxandxrequirements,xbutxreceivesxsharedxsaving
sxbonusesxbasedxonxachievementxofxbenchmarksxforxqualityxmeasuresxandxexpenditures.xCarexcoord
inationxandxminimumxcashxreservesxstandardsxarexpartxofxLevelx2xACOxrequirements.xLevelx3xACO
sxhavexstrictxrequirementsxforxfinancialxreporting.xREF:xAccountablexCarexOrganizations
, Buttaro:x PrimaryxCare,x Ax Collaborativex Practice,x5thx Ed.
Chapterx 2:xTransitionalx Carex
TestxBank
MultiplexChoice
1. Toxreducexadversexeventsxassociatedxwithxcarextransitions,xthexCentersxforxMedicarexandxMedic
aidx Servicex haveximplementedx whichx policy?
a. Mandatesxforxcommunicationx amongx primaryx caregiversx andxhospitalists
b. Penaltiesx forx failurex toxperformxmedicationx reconciliationsx atxtimex ofxdischargexc.
x Reductionxofxpaymentsx forx patientsx readmittedx withinx 30xdaysx afterx discharge
d.x Requirementsx forxwrittenx dischargex instructionsx forxpatientsx andxcaregivers
ANS:x C
AsxaxcomponentxofxthexAffordablexCarexAct,xthexCentersxforxMedicarexandxMedicaidxServicexdevel
opedxthexReadmissionsxReductionxProgramxreducingxpaymentsxforxcertainxpatientsxreadmittedxwith
inx30xdaysxofxdischarge.xThexCMSxdidxnotxmandatexcommunication,xinstitutexpenaltiesxforxfailurexto
xperformxmedicationxreconciliations,xorxrequirexwrittenxdischargexinstructions.x REF:x Transitionalx
Care
2. AccordingxtoxNaylor’sxtransitionalx carexmodel,x whichx interventionx hasx resultedx inxlowerxcostsxa
ndx fewerx rehospitalizationsxinx high-riskx olderx patients?
a. Coordinationx ofxpost-hospitalx carexbyxadvancedx practicex nurses
b. Frequentx post-hospitalx clinicx visitsx withx axprimaryx carexprovider
c. Inclusionx ofxextendedx familyx membersx inxxthex outpatientx planx ofxcare
d. Telephonex followx upxbyxthex pharmacistx tox assessxmedicationx compliance
ANS:x A
Naylor’sxtransitionalxcarexmodelxprovidedxevidencexthatxhighxriskxolderxpatientsxwhoxhadxpost-
xhospitalxcarexcoordinatedxbyxanxAPNxhadxreducedxrehospitalizationxrates.xItxdidxnotxincludexclinicxv
isitsxwithxaxprimaryxcarexprovider,xinclusionxofxextendedxfamilyxmembersxinxthexplanxofxcare,xorxtele
phonexfollowx upx byxaxpharmacist.x REF:x Transitionalx Care
3. WhichxapproachesxarexamongxthosexrecommendedxbyxthexAgencyxforxHealthcarexResearchxand
x Qualityx tox improvex healthx literacyx inx patients?
Selectxallxthatxapply.
a. Empoweringx patientsxandxfamilies
b. Givingx writtenx handoutsx forxallxteaching
