AHIP AHM-540 問題集

質問 1：
For this question, if answer choices (A) through (C) are all correct, select answer choice (D). Otherwise, select the one correct answer choice.
Many health plans use data warehouses to assist with the performance of medical management activities. With respect to the characteristics of data warehouses, it is generally correct to say
A. all of the above
B. that the construction of a data warehouse is quick and simple
C. that a data warehouse stores only current data
D. that a data warehouse addresses the problems associated with multiple data management systems
正解：D

質問 2：
The Hall Health Plan gathered objective clinical information about the recommended uses and dosages of angiotensin-converting enzyme (ACE) inhibitors and presented the information to network providers to illustrate the appropriate use of these frequently prescribed and expensive drugs. This information indicates that Hall most likely educated its network providers through the use of
A. drug efficacy study implementation (DESI)
B. cognitive services
C. detailing
D. counter detailing
正解：D

質問 3：
Emilio Martinez, a member of the Bloom Health Plan, has recently been diagnosed with prostate cancer by his physician, Dr. Robert Cohen. Mr. Martinez has decided to participate in Bloom's shared decision-making program for prostate cancer. On the basis of this information, it is most likely correct to say
1.That verification of Mr. Martinez's understanding about his care options protects both Dr. Cohen and Bloom against charges of malpractice 2.That Mr. Martinez and Dr. Cohen will discuss the care options available to Mr. Martinez, but the ultimate decision about care is up to Dr. Cohen
A. Neither 1 nor 2
B. 2 only
C. Both 1 and 2
D. 1 only
正解：A

質問 4：
The following statements are about medical management considerations for dental care. Select the answer choice containing the correct statement.
A. Managed dental plans are accredited by the National Association of Dental Plans (NADP).
B. Dental preferred provider organizations (Dental PPOs) are subject to more regulation than are dental health maintenance organizations (DHMOs).
C. Managed dental care organizations are regulated at the state rather than the federal level.
D. Dental care differs from medical care in that most dental care is provided by specialists.
正解：C

質問 5：
Accreditation is intended to help purchasers and consumers make decisions about healthcare coverage.
The following statements are about accreditation. Select the answer choice containing the correct statement.
A. At the request of health plans, accrediting agencies gather the data needed for accreditation.
B. Most purchasers and consumers review accreditation results when making decisions to purchase or enroll in a specific health plan.
C. All health plans are required to participate in the accreditation process.
D. Accreditation is typically conducted by independent, not-for-profit organizations.
正解：D

質問 6：
To improve members' abilities to make appropriate care decisions about specific medical problems, some health plans use a form of decision support known as telephone triage programs. The following statements are about telephone triage programs. Select the answer choice containing the correct statement.
A. A telephone triage program may also include a self-care component.
B. Quality management (QM) for telephone triage programs typically focuses on the clinical information provided rather than on the quality of service.
C. The primary role of telephone triage clinical staff is to diagnose the caller's condition and give medical advice.
D. Currently, none of the major accrediting agencies offers an accreditation program specifically for telephone triage programs.
正解：B