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AHIP AHM-540 Dumps

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Medical Management
Last Update: Jul 10, 2024
163 Questions
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Medical Management Practice Questions

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Medical Management Questions and Answers

Questions 1

As a follow-up to a performance improvement plan for member services, the Stellar Health Plan conducted an evaluation of the success of the plan. Stellar conducted its evaluation as the plan was being carried out. The evaluation focused on specific activities and assessed the relative importance of those activities to the plan as a whole. This information indicates that Stellar’s evaluation of the plan was both



concurrent and formative


concurrent and summative


retrospective and formative


retrospective and summative

Questions 2

The paragraph below contains two pairs of terms or phrases enclosed in parentheses. Determine which term or phrase in each pair correctly completes the paragraph. Then select the answer choice containing the two terms or phrases that you have selected.

The process for collecting and analyzing data differs for quality assessment (QA) and quality improvement (QI). For QA, data collection focuses on (objective / both objective and subjective) data, and data analysis identifies the (degree / cause) of variance.



objective / degree


objective / cause


both objective and subjective / degree


both objective and subjective / cause

Questions 3

Health plan performance measures include structure measures, process measures, and outcome measures. The following statements are about the characteristics of these three types of performance measures. Three of the statements are true and one is false. Select the answer choice containing the FALSE statement.



The most widely used structure measures relate to physician education and training.


One advantage of structure measures over process measures is that structures are often linked directly to healthcare outcomes.


Process measures are useful in identifying underuse, overuse, and inappropriate use of services.


One disadvantage of outcome measures is that they can be influenced by factors outside the control of the health plan.