Buttaro: Primary Care, A Collaborative Practice, 5th Ed.
Chapter 1: The Evolving Landscape of Collaborative Practice
Test Bank
Multiple Choice
1. Which assessments of care providers are performed as part of the Value Based Purchasing
initiative?
Select all that apply.
a. Appraising costs per case of care for Medicare patients
b. Assessing patients’ satisfaction with hospital care
c. Evaluating available evidence to guide clinical care guidelines
d. Monitoring mortality rates of all patients with pneumonia
e. Requiring advanced IT standards and minimum cash reserves
ANS: A, B, D
Value Based Purchasing looks at five domain areas of processes of care, including efficiency of
care (cost per case), experience of care (patient satisfaction measures), and outcomes of care
(mortality rates for certain conditions. Evaluation of evidence to guide clinical care is part of
evidence-based practice. The requirements for IT standards and financial status are part of
Accountable Care Organization standards. REF: Value Based Purchasing
2. What was an important finding of the Advisory Board survey of 2014 about primary care
preferences of patients?
a. Associations with area hospitals
b. Costs of ambulatory care
c. Ease of access to care
d. The ratio of providers to patients
ANS: C
As part of the 2014 survey, the Advisory Board learned that patients desired 24/7 access to care,
walk-in settings and the ability to be seen within 30 minutes, and care that is close to home.
Associations with hospitals, costs of care, and the ratio of providers to patients were not part of
these results. REF: The New Look of Primary Care
3. A small, rural hospital is part of an Accountable Care Organization (ACO) and is designated
as a Level 1 ACO. What is part of this designation?
a. Bonuses based on achievement of benchmarks
,Test Bank 2
b. Care coordination for chronic diseases
c. Standards for minimum cash reserves
d. Strict requirements for financial reporting
ANS: A
A Level 1 ACO has the least amount of financial risk and requirements, but receives shared savings
bonuses based on achievement of benchmarks for quality measures and expenditures. Care
coordination and minimum cash reserves standards are part of Level 2 ACO requirements. Level
3 ACOs have strict requirements for financial reporting. REF: Accountable Care Organizations
Copyright © 2016, Elsevier Limited. All rights reserved.
,Buttaro: Primary Care, A Collaborative Practice, 5th Ed.
Chapter 2: Transitional Care
Test Bank
Multiple Choice
1. To reduce adverse events associated with care transitions, the Centers for Medicare and
Medicaid Service have implemented which policy?
a. Mandates for communication among primary caregivers and hospitalists
b. Penalties for failure to perform medication reconciliations at time of discharge
c. Reduction of payments for patients readmitted within 30 days after discharge
d. Requirements for written discharge instructions for patients and caregivers
ANS: C
As a component of the Affordable Care Act, the Centers for Medicare and Medicaid Service
developed the Readmissions Reduction Program reducing payments for certain patients readmitted
within 30 days of discharge. The CMS did not mandate communication, institute penalties for
failure to perform medication reconciliations, or require written discharge instructions. REF:
Transitional Care
2. According to Naylor’s transitional care model, which intervention has resulted in lower costs
and fewer rehospitalizations in high-risk older patients?
a. Coordination of post-hospital care by advanced practice nurses
b. Frequent post-hospital clinic visits with a primary care provider
c. Inclusion of extended family members in the outpatient plan of care
d. Telephone follow up by the pharmacist to assess medication compliance
ANS: A
Naylor’s transitional care model provided evidence that high risk older patients who had post-
hospital care coordinated by an APN had reduced rehospitalization rates. It did not include clinic
visits with a primary care provider, inclusion of extended family members in the plan of care, or
telephone follow up by a pharmacist. REF: Transitional Care
3. Which approaches are among those recommended by the Agency for Healthcare Research
and Quality to improve health literacy in patients?
Select all that apply.
a. Empowering patients and families
b. Giving written handouts for all teaching
, Test Bank 2
c. Highlighting no more than 7 key points
d. Repeating the instructions
e. Supplementing teaching with visual aids
ANS: A, D, E
AHRQ recommends using clear, simple language, highlighting 3 to 5 key points, using pictures or
visual aids, repeating the instructions, using Teach Back, and empowering patients. Written
communication is not part of the recommendations. REF: Health Literacy
Copyright © 2016, Elsevier Limited. All rights reserved.
