Hcqm - Study guides, Class notes & Summaries

HCQM TRANSITIONS OF CARE EXAM LATEST UPDATE...

Accountable Care Organizations exception - Answer Exempt when participating in a Medicare Shared Savings Program or when making distributions of shared savings it earned through the MSSP to participants in the ACO and for limited patient inducements for remuneration given to ACO beneficiaries. Self Referral Disclosure Protocol - Answer Entity can submit information to CMS or OIG about a Stark Law violation. CMS may reduce the amount a provider would otherwise owe to the government but is n...

Basic common threads of Quality Management. - correct answer Examine the processes leading to the delivery of care, the outcomes expected from the care, and the degree to which the expected outcomes are reached. Abraham Flexner - correct answer Quality should be measured. E.A. Codman, MD - correct answer Boston surgeon from the early 1900's was a public health pioneer studying hospital outcomes to determine how they could be improved. Founded by E.A. Codman - correct answer American Co...

Re-Engineered Hospital Discharge Intervention (Project RED) - Answer Led by Brian Jack - utilization of nurse discharge advocates who collaborate with the patient/caregivers to assess, plan and develop a coordinate approach for transition to the next level of care. Includes a post discharge conversation with the patient to discuss plan and focus on medications. Primary care physician/discharge advocate are notified if there are questions. Louise - Answer Computerized avatar part of Project...

Medicaid Integrity Program - Answer Established in 2005 by the Deficit Reduction Act. Used funding to contract with Program Safeguard Contractors who perform data analysis, develop fraud cases, support law enforcement and assist CMS in imposing administrative actions based on payment types within a certain geographic area. 18 PSCs were created. Two information technology system programs established by CMS in 2006 to improve its ability to detect fraud, waste, and abuse - Answer Integrated ...

HCQM CLINICAL RESOURCE MANAGEMENT EXAM WITH QUESTIONS AND ANSWERS ...

4 sets of CLIA rules - Answer 1. laboratory standards 2. application and user fees 3. enforcement procedures 4. approval of accreditation programs 8 Benefits of Accreditation - Answer 1. improved patient outcomes 2. organizational learning 3. providing professional consultation and enhancement of staff education 4. ongoing support from accrediting body 5. decrease liability d/t mitigation of risk for adverse events 6. recognition by carriers and hmos 7. increased financial capabilities 8. ...

ABQUARP (HCQM) EXAM QUESTIONS AND ANSWERS GRADED A+