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Quiz Session - Attempts With Random Questions

CCMC CCM Exam Questions

Page 4 of 25

61.

What is the most accurate statement regarding Prospective Payment Systems (PPS)?

  • They are designed to promote efficiency

  • They are designed to maximize revenue per service

  • They decide on payments after the fact

  • They are not related to direct patient care 

Correct answer: They are designed to promote efficiency

A Prospective Payment System (PPS) is a reimbursement method in which care is provided based on a predetermined, fixed amount. This approach is designed to promote and enforce efficiency in the entire system of care.

A PPS is not designed to maximize revenue per service, and this type of system decides on payments in advance. A PPS is highly related to the provision of direct patient care.

62.

About how many people are served in custodial care/boarding care settings?

  • 4 to 6 patients per setting

  • 1 patient per setting

  • 10 patients per setting

  • Up to 50 patients per setting

Correct answer: 4 to 6 patients per setting

Custodial care/boarding settings are those which give total care to a small number of patients. About 4 to 6 patients are usually served in individual custodial care/boarding care settings.

63.

Which of the following is a likely type of treatment in inpatient psychiatric care?

  • Psychiatric stabilization

  • Long-term therapy

  • Classical psychoanalysis

  • Residential treatment

Correct answer: Psychiatric stabilization

In terms of level of care, the emphasis in inpatient psychiatric care is psychiatric stabilization. This is a relatively short-term process, with the goal being the return of the patient to the community as quickly as the remission of their symptoms permit.

Long-term therapy, classical psychoanalysis, and residential treatment are all long-term treatments that would be outside the scope of inpatient psychiatric care.

64.

Which of the following is the most accurate statement regarding the payment implications of the CAHPS survey?

  • Hospitals must collect and submit the data to receive full payment updates

  • Hospitals must collect and submit the data to meet state regulatory requirements

  • Hospitals must collect and submit the data to meet international coding standards

  • There are no payment implications of the CAHPS survey per se

Correct answer: Hospitals must collect and submit the data to receive full payment updates

The Consumer Assessment of Healthcare Providers and Systems (CAHPS or HCAHPS) is a patient assessment of their experience in healthcare. In order to receive their full Inpatient Prospective Payment System (IPPS) annual payment update, hospitals subject to IPPS must collect and submit this data.

The payment implications of collecting this data are not a matter of state regulation or international coding standards.

65.

Which of the following is the least significant reason for patient ambivalence to changing health behaviors?

  • Disease process

  • Lack of belief in ability to change 

  • Readiness to change 

  • Lack of support for change 

Correct answer: Disease process

When patients are ambivalent about changing health behaviors, it tends to be in spite of, rather than due to, disease process. In fact, the extant or potential disease process may be one of the main drivers of change.

Ambivalence is a state defined by the inability to commit to a change plan. Though there are many reasons for this, some of the most significant are readiness, non-belief in one's ability to change, no plan, and no support for the change.

66.

Which of the following is the least likely direct psychological consequence of major illness and/or injury?

  • Delusions

  • Anger

  • Dependency

  • Anxiety

Correct answer: Delusions

A person who is diagnosed with a major illness, or who experiences a major injury, is likely to experience a range of adjustments to the circumstances. Many possible reactions exist, such as anger, developing a dependence on others, and anxiety.

Delusions are more a symptom of acute mental illness and are less likely to emerge as a reaction to a change in health status.

67.

Which of the following models of transitional care uses "embedded case managers"?

  • Proven Health Navigator

  • Patient Activation Model

  • Coleman's model of care transitions

  • Qualis Health Initiative 

Correct answer: Proven Health Navigator 

The Proven Health Navigator model is distinguished by its use of "embedded case managers" that help coordinate care across systems.

The Patient Activation Model is an approach of engaging patients. Coleman's model of care transitions uses transitions coaching instead of embedded case managers. The Qualis Health Initiative is a model of healthcare innovation that concentrates on coordinating quality across systems.

68.

Which of the following would be least likely to be an inpatient quality indicator (IQI)?

  • Transfusion reaction

  • Hip fracture mortality rate

  • Abdominal aortic aneurysm repair volume

  • Carotid endarterectomy volume

Correct answer: Transfusion reaction

Inpatient Quality Indicators (IQI) are quality measures meant to assess the quality of care in inpatient settings and surgical procedures within those settings. Examples include hip fracture mortality rate, abdominal aortic aneurysm repair volume, and carotid endarterectomy volume.

Transfusion reaction would be considered a preventable safety event and would be an example of a Patient Safety Indicator (PSI), as it refers to an event that is preventable inside a healthcare system.

69.

What is the purpose of the Mini-Mental Status Exam?

  • To assess cognitive function 

  • To assess neurological damage

  • To assess brain injury

  • To assess depression

Correct answer: To assess cognitive function 

The Mini-Mental Status Exam is an assessment of cognitive function. It is designed to give the clinician a good "snapshot" of the cognitive ability of the patient at the current time.

The Mini-Mental Status Exam does not assess neurological damage, depression, or brain injury, but may register their cognitive effects.

70.

Which of the following would not be treated by vision therapy?

  • Nearsightedness 

  • Amblyopia

  • Visual processing disorders

  • Ocular motor dysfunctions

Correct answer: Nearsightedness 

Vision therapy is a kind of rehabilitation that seeks to restore lost visual function. It addresses such things as amblyopia, visual processing disorders, and ocular motor dysfunctions.

This kind of therapy would most likely not treat nearsightedness, which could be adequately addressed by ordinary optometry.

71.

Which of the following uses "transitions coaches"?

  • Coleman's model of care transitions

  • Proven Health Navigator

  • Patient Activation Model

  • Qualis Health Initiative

Correct answer: Coleman's model of care transitions

Coleman's model of care transitions uses "transitions coaches" to guide the patient across the continuum of care.

The Proven Health Navigator model uses "embedded case managers" that help coordinate care across systems. The Patient Activation Model is an approach of engaging patients. The Qualis Health Initiative is a model of healthcare innovation that concentrates on coordinating quality across systems. 

72.

Which of the following is not a step in the Patient Activation Model (PAM)?

  • Auditing engagement

  • Disengaged and overwhelmed

  • Taking action toward engagement

  • Maintaining gainful behaviors

Correct answer: Auditing engagement

The purpose of the Patient Activation Model (PAM), created by Insignia Health, is to engage patients by creating a single point of contact within the system and motivating and moving patients through a stepwise process toward greater engagement in their own care.

The process contains four steps:

  • Disengaged and overwhelmed
  • Struggling with the plan of care
  • Taking action toward engagement
  • Maintaining gainful behaviors

Auditing the engagement of the patient is not a step in the process per se. 

73.

In facilities operating on a day rate, when does the new billing "day" usually start?

  • Midnight 

  • At treatment planning

  • Morning shift change

  • Evening shift change

Correct answer: Midnight 

In most facilities operating on a day rate, the new billing "day" starts at midnight and runs until the next midnight.

Treatment planning and shift change are highly variable occasions and are not usually a billing occasion per se.

74.

What is the focus of Value-Based Purchasing?

  • Quality of care for Medicare beneficiaries

  • Quality of care for Medicaid beneficiaries

  • Quality of care for VA beneficiaries

  • Quality of care in any acute care hospital

Correct answer: Quality of care for Medicare beneficiaries

Value-Based Purchasing (VBP) is a CMS initiative that seeks to incentivize certain quality of care indicators with direct payments if these measures are achieved. Examples might include patient experiences of the care domain and the efficiency domain. 

VBP is not addressed toward Medicaid or VA beneficiaries, and is specifically addressed toward Medicare beneficiaries and not any recipient of services in an acute care hospital.

75.

Which part of Medicare generally pays for outpatient services?

  • Part B

  • Part A

  • Part C

  • Part D

Correct answer: Part B

Medicare Part B covers professional fees, diagnostics, and outpatient services. 

Part A covers hospital care, laboratory services, surgery, and hospice, among other areas. Part C refers to a Managed Medicare plan. Part D pays for pharmaceutical drugs.

76.

Which of the following would be considered a measure of outcome? 

  • Patient mortality

  • Percentage of patients vaccinated

  • Percentage of patient screened for COVID-19

  • Staffing ratios

Correct answer: Patient mortality 

Measures of outcome document what happens to patients as a result of their involvement with the care system, such as patient mortality.

Percentage of patients vaccinated or screened for COVID-19 would be considered measures of process, as they measure things that the care system does. Staffing ratios would be a measure of structure, as it assesses the ability of a healthcare system to meet patient needs.

77.

Can Medicaid coverage ever be retroactive?

  • Yes, for up to three months

  • No, under no circumstances

  • Yes, with no time limit

  • Yes, for up to a year

Correct answer: Yes, for up to three months

Medicaid coverage can be retroactive for up to three months prior to filing the application, if the person would have been eligible when services were received.

78.

Is there a life-expectancy expectation with respect to involvement with palliative care?

  • No

  • Yes, a patient involved with palliative care is expected to live for six months or less

  • Yes, a patient involved with palliative care is expected to live for three months or less

  • Yes, a patient involved with palliative care is expected to live for one year or less

Correct answer: No

Palliative care is a system of care designed to manage the symptoms of chronic illness. In contrast with hospice, where an enrolled patient is expected to live about six months or less, palliative care is available to eligible patients throughout the course of their treatment for as long as that treatment may go. 

79.

Which of the following is least likely to be covered by Medicaid?

  • Vocational training

  • Mental health care

  • Medications

  • Vision care for children

Correct answer: Vocational training

Medicaid is a state-administered system that offers variable benefits according to state, all of which are intended to help those whose financial resources are not adequate to pay for care under specific federal guidelines. Depending on the jurisdiction, Medicaid can help pay for things such as mental health care, medications, and vision care for children.

Medicaid generally does not cover vocational training.

80.

Which of the following does URAC do?

  • It accredits healthcare organizations 

  • It governs medical practice

  • It governs psychiatric practice

  • It measures and reports outcomes

Correct answer: It accredits healthcare organizations 

URAC (Utilization Review Accreditation Committee) accredits healthcare organizations in general and specific ways. The process is voluntary and is highly concerned with case management as a driver of quality.

URAC does not govern medical practice or psychiatric practice. It is not primarily involved in measuring and reporting outcomes. 

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