AHIP AHM-250 問題集

質問 1：
Some providers use electronic medical records (EMRs) to document their patients' care in an electronic form. The following statement(s) can correctly be made about EMRs:
A. A only
B. B only
C. EMRs are computerized records of a patient's clinical, demographic, and administrator
D. Both A and B
E. Neither A nor B
正解：E

質問 2：
One way in which a health plan can support an ethical environment is by
A. developing and maintaining a culture where ethical considerations are integrated into decision making at the top organizational level only
B. maintaining control of policy development by removing providers and members from the process of developing and implementing policies and procedures that provide guidance to providers and members confronted with ethical issues
C. requiring organizations with which it contracts to adopt the plan's formal ethical policy
D. establishing a formal method of managing ethical conflicts, such as using an ethics task force or bioethics consultant
正解：D

質問 3：
The Ark Health Plan, is currently recruiting providers in preparation for its expansion into a new service area. A recruiter for Ark has been meeting with Dr. Nan Shea, a pediatrician who practices in Ark's new service area, in order to convince her to be
A. Has ever participated in any quality improvement activities.
B. Meets the requirements of the Ethics in Patient Referrals Act.
C. Has had a medical malpractice claim filed or other disciplinary actions taken against her.
D. Is a participating provider in a health plan that will compete with Ark in its new service area.
正解：C

質問 4：
One characteristic of the accreditation process for MCOs is that
A. an accrediting agency typically conducts an on-site review of an MCO's operations, but it does not review an MCO's medical records or assess its member service systems
B. government agencies conduct all accreditation activities for MCOs
C. each accrediting organization has its own standards of accreditation
D. the accrediting process is mandatory for all MCOs
正解：C

質問 5：
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The following programs are part of the Alcove Health Plan's utilization management (UM) program:
Preventive care initiatives
A telephone triage program
A shared decision-making program
A self-care program
With regard to the UM programs, it is most
A. Shared decision-making program is appropriate for virtually any medical condition.
B. Self-care program is intended to complement physicians' services, rather than to supersede or eliminate these services.
C. Preventive care initiatives include immunization programs but not health promotion programs.
D. Telephone triage program is staffed by physicians only.
正解：B

質問 6：
The Mosaic health plan uses a typical electronic medical record (EMR) to document the medical care its members receive. One characteristic of Mosaic's EMR is that it:
A. Does not provide any clinical decision support for Mosaic's providers.
B. Contains a Mosaic member's clinical data only.
C. Is designed to supply information at the site of care.
D. Is organized by the type of treatment or by provider.
正解：C

質問 7：
Specialty services with certain characteristics tend to make good candidates for health plan approaches. One characteristic used to identify a specialty service that may be a good candidate for a health plan approach is that the service should have
A. a defined patient population
B. a complex benefit structure
C. appropriate utilization rates
D. low, stable costs
正解：A