Module 9

Question 1

Which of the following is a patient care delivery model where patient treatment is coordinated?

A. The traditional gatekeeper model
B. The national health insurance model
C. The patient-centered medical home (PCMH)

Answer 1

C. The patient-centered medical home (PCMH)

Question 2

This encourages providers to develop and implement interdisciplinary, interprofessional care plans that integrate clinical and community preventative and health promotion services for patients:

A. The National Committee for Quality Assurance (NCQA) three-tier recognition process.

B. Section 3502 of the ACA

C. The CARES Act

Answer 2

B. Section 3502 of the ACA

Question 3

Which of the following is the main organization involved in PCMH recognition?

A. National Committee for Quality Assurance (NCQA)

B. Department of Health and Human Services

C. The Joint Commission and the Accreditation Commission for Health Care.

Answer 3

A. National Committee for Quality Assurance (NCQA)

Question 4

Which of the following is a fully integrated approach of information technology that includes outreach, coordination, and follow-up protocols?

A. Telemedicine
B. Electronic Health Records
C. Desktop Medicine

Answer 4

C. Desktop Medicine

Question 5

This encourages patients to be more educated about their illnesses and proactive in maintaining improved health outcomes.

A. Health information technology
B. Shared decision making
C. Surveys of patient satisfaction and engagement

Answer 5

B. Shared decision making

Question 6

All of the following are basic features that distinguish the PCMH model from the traditional care delivery model, EXCEPT:

A. A team-practice approach

B. Integration of health information technology

C. Physician-centered engagement in care

Answer 6

C. Physician-centered engagement in care

Question 7

Which of the following best describes reimbursement methods for PMCHs?

A. A monthly care-coordination payment supporting the medical home structure

B. A visit-based, fee-for-service component

C. A performance-based component

D. A blend of all the above payment-approach elements

Answer 7

D. A blend of all the above payment-approach elements

Question 8

A coordinated care delivery model with treatment when and where patients need it.

Answer 8

Patient-Centered Medical Home (PCMH)

Question 9

Defines a PCMH as a mode of care with personal physicians, a whole person orientation, coordinated & integrated care, safe & high-quality care through evidence-based medicine, use of HIT & continuous quality improvements, expanded access to care, & payment that recognizes value of patient-centered components.

Answer 9

Section 3502 of the ACA

Question 10

The first point of contact and an ongoing coordinator of comprehensive, patient-centered services.

Answer 10

The primary care physician role in a PCMH

Question 11

Integration of health information technology, patient-centered engagement, and a team-practice approach.

Answer 11

Key features of a PCMH

Question 12

Introduced as a coordinated care model for children and brought back in the ACA in response to problems with primary care (a lack of coordination, a lack of communication among providers, and fee-for –service payments).

Answer 12

Evolution of the PCMH concept

Question 13

A process for accrediting PCMHs. Elements include access during office hours, use of data for patient population management, supporting the patient self-care process, referral tracking and follow-up, and continuous quality improvement.

Answer 13

National Committee for Quality Assurance (NCQA) three-tier recognition process

Question 14

This allows for integration of processes such as appointment scheduling, follow-up, and evaluation of patient populations.

Answer 14

Use of health information technology

Question 15

A fully integrated approach of IT that includes outreach, coordination, and follow-up protocols.

Answer 15

Desktop medicine:

Question 16

When practices adapt to patient needs and focus on access and patient involvement in care, building long-term relationships.

Answer 16

Patient engagement in care

Question 17

This helps with a patient’s adherence to a course of treatment or self-management of a condition.

Answer 17

Shared decision making

Question 18

This approach to patient care is one of the key differences between PCMHs and the traditional gatekeeper model.

Answer 18

Team approach to patient care

Question 19

Involves a monthly care coordination payment, a visit-based fee-for-service component, and a performance-based component based on quality and efficiency.

Answer 19

Blended model for reimbursement methods

Question 20

PCMHs achieve this with open scheduling, post-visit follow-up, and 24-hour access to primary care advice.

Answer 20

Improving access and enhanced coordination of patient care

Question 21

The IT component of medical homes helps federal monitoring of this. Providers must use a certified electronic health record system, meet objectives, and report quality measures.

Answer 21

Meaningful use standards

Question 22

Differences in clinical focus, transformation processes, & payment arrangements. Flexibility encourages provider adoption and innovation, but it makes it difficult to compare success.

Answer 22

Variability in definition of the PCMH model

Question 23

Using telemedicine and alternative sources of care risks jeopardizing care coordination when accessed outside of systems providing for comprehensive, integrated care.

Answer 23

Disruptive elements of COVID-19

Question 24

Currently, the patient-centered medical home (PCMH) includes all of the following features, EXCEPT:

A. Integration of health information technology

B A well-funded design

C. Patient-centered engagement in care

D. A team-practice approach

E. A focus on improved health, better patient satisfaction, and reductions in cost, the goals of the Triple Aim

Answer 24

Answer: B. Funding is an issue many entities are still dealing with. (Text, pp. 237-239 and 252-
253)

Question 25

Areas requiring improvement for PCMHs to achieve their potential are:

A. Funding methodology

B. Expectations on the timeline for transformation

C. Variation in reimbursement methods and medical home setup

D. All of the above

Answer 25

Answer: D (Text, pp. 251-252)

Question 26

All of the following are lessons learned from the COVID-19 pandemic, EXCEPT:

A. Telehealth is convenient but presents concerns with coordination of care.

B. Urgent care is relatively affordable but presents concerns with coordination of care.

C. Primary care physicians experienced disruption from the COVID-19 pandemic.

D. Some individuals started using urgent care centers as their primary source of care.

E. Accessing care with alternative channels supports the PCMH model

Answer 26

Answer: E (Text, pp. 261-263) PCMHs stress a coordinated care delivery approach, which is challenged by accessing care through multiple alternative channels.