Deck 12: Payment and Quality

Question 1

Which of the following statements about payment model incentives is/are TRUE?

A) Fee-for-service and capitation payment models have opposite incentives for the amount of treatment delivered
B) Fee-for-service and capitation are provider centric and do not incent concern for patient quality or outcomes
C) Fee-for-service and capitation are patient centric and incent concern for patient quality or outcomes
D) A and B
E) A and C

Answer 1

D

Question 2

When comparing the health systems of the US and OECD countries, which of the following statements is/are FALSE?

A) The US always has the highest cost and highest quality
B) The OECD countries always have the lowest cost and highest quality
C) The US always has the highest cost and lowest quality
D) The US has the largest global economy, largest research & production hub, & the lowest quality
E) Until recently, the US has never tied quality or outcomes to payment

Answer 2

A

Question 3

Which of the following statements describes how patients view quality?

A) Efficacy of treatment
B) Adherence to evidence-based practice guidelines
C) Treated with respect and dignity
D) A and B
E) A and C.

Answer 3

E

Question 4

Which of the following statements describes how providers view quality?

A) Efficacy of treatment
B) Adherence to evidence-based practice guidelines
C) Treated with respect and dignity
D) A and B
E) A and C

Question 5

Which of the following statements about evidence-based practice guidelines is/are FALSE?

A) Clinical quality and treatment outcomes are based on adherence to evidence-based practice guidelines
B) Evidence-based practice guidelines is based on clinical research
C) Evidence-based practice guidelines are published in medical journals
D) It takes 7 years to adopt evidence-based practice guidelines that become obsolete within 10 years
E) It takes 17 years to adopt evidence-based practice guidelines that become obsolete within 10 years

Question 6

Which of the following statements about quality related events (2003) is/are FALSE?

A) AHRQ launched its annual health quality & disparities reports
B) Pay-for-performance program was launched rewarding physicians for adhering to evidence-based treatment guidelines
C) Pay-for-performance increased physician payment & improved quality
D) Current (2015) AHRQ reports indicate quality has improved
E) Current (2015) AHRQ reports indicate disparities have not improved

Question 7

Which of the following statements about Patient Centered Medical Homes (PCMH) is/are TRUE?

A) PCMHS began in 1967 by pediatrics with the purpose of care coordination
B) PCMHs began in 1967 by adult PCPs with the purpose of care coordination
C) Both PCMHs and the current payment model are patient centric
D) PCMHs can easily be assimilated into current PCP models
E) While the ACA encourages PCMHs, it provides no practice development funds

Question 8

Which of the following statements BEST describes Accountable Care Organizations (ACO)?

A) ACOs are based on a Medicare waiver program that coordinated cardiac care
B) ACOs are effective coordinating care but ineffective decreasing costs
C) ACOs require risk sharing that is easily tolerated by provider organizations
D) ACOs that left the program did so for operational reasons
E) ACOs are developing at a rapid pace with CMS anticipating all payment models will be transitioned to negative and positive risk sharing models by 2017

Question 9

Which of the following statements about Value Based Purchasing (VBP) and episode of care payment models is/are FALSE?

A) Both payment models positively reward quality of care
B) VBP rewards are based on clinical quality outcomes
C) VBP is a revenue neutral payment model
D) Episode of care payment models provide payment incentives for keeping patients out of the hospital
E) Episode of care payment successes have a geographical component

Question 10

Which of the following statements about payment models promulgated from the ACA is/are TRUE?

A) ACA promulgated payment models have resulted in significant changes in delivery & payment for healthcare services
B) ACA promulgated payment models have resulted in model redesign proceeding payment redesign
C) ACA promulgated payment models based on outcomes is an innovative payment approach
D) ACA promulgated payment models have resulted in a major organizational paradigm shift
E) All of the above

Question 11

Describe the arc of healthcare payment change to improve quality.

Question 12

Describe the evolution of nonpayment-driven efforts to improve quality.

Question 13

Describe the interplay between private sector efforts and government efforts.

Question 14

Describe the forces leading to the linking of payment and quality in CMS policy.