Population Health disease management questions from courses

Why does population health need to be managed?
a. To provide a fair system of rationing care
b. Because individuals are not capable of managing without supervision
c. Because health care resources are finite and expenditures continue to increase
d. To identify gaps in service and develop programs to fill those gaps
C
Which of the following is a factor
in determining health?
a. Socioeconomic status
b. Social support
c. Genetics
d. All of the above
D
Are individuals taking more
responsibility for their health and medical care?
Yes, as demonstrated by the growth of media, the Internet, and other sources that people use to get information and the growth of health promotion programs
No, as demonstrated by the failure of information sources and programs to reduce the prevalence of chronic diseases.
yes
Demand management tools are used:
a. To entice consumers to use discounted services during off-peak hours
b. To provide utilization review prior to and during the course of hospital admissions
c. To control costs by assisting consumers in seeking appropriate health care
d. All of the above
C
Disease management programs target common chronic diseases, such as:
a. Heart disease and asthma
b. Diabetes and malaria
c. Arthritis and gout
d. All of the above
A
Catastrophic cases are thought to represent less than 1 percent of all health care claims, but are responsible for what percentage of costs? (Points : 1)
a. Less than 5 percent
b. 20 percent to 30 percent
c. More than 75 percent
d. This is unknown because such statistics are not kept by insurers
B
The focus of disability management is on:
a. People with catastrophic injuries
b. People who use wheelchairs and other assistive devices
c. People who have been out of work longer than one year
d. People who are employed and may face significant lost work time
D
Factors that influence the length
of a disability include:
a. Relationship with co-workers or supervisor
b. Satisfaction with work tasks
c. Litigation
d. All of the above
D
Which statement related to the
definition of disease management (DM) is correct?
a. DM is a set of prospectively determined interventions used to alter the course of a disease.
b. DM is a medical management measurement.
c. DM does not include a multidisciplinary focus on health.
d. DM is focused only on the cure of the disease.
A
Some factors driving the growth
of disease management include all of the following except:
a. Increase in managed care systems
b. Decreased consumption
c. The need to revamp practices that fragment care
d. The need to coordinate care across settings over time
D
Case managers dealing with any
given disease must understand which of the following:
a. Cost and quality influence and cause of clinical outcome
b. How to prevent all illness from ever occurring
c. How to treat only more complicated end stages of a disease
d. None of the above
A
Which professional organization
represents the disease management community?

a. AAHP
b. CNA
c. DMAA
d. DME

C
.Some of the most common barriers to maintaining successful disease management programs include turnover, level of patient needs, and responsibilities.
True
False
true
A professional may take the
following steps to facilitate disease management, except:
a. Inform all patients that it is not their responsibility to manage their disease
b. Motivate the patient and others to participate actively in the management
c. Improve the patient’s ability to identify and eliminate barriers to actively participate in the rehab program
d. Reinforce the importance of the patient’s active participation
A
An example of an insurance
company is:
a. Delaware Health Care Associates
b. Blue Cross-Blue Shield
c. Center for Health Professionals
d. Professional Patient Care Unit.
B
The definitions of the
scholarly/research and miscellaneous groups differ most significantly.
True
False
true
Which of the following is a
component of disease management programs?
a. Identification of the population
b. Establishing a collaborative practice model
c. Process and outcome measurement
d. All of the above
D
Major strategies of disease
management programs include all, except:
a. Collaborative team of physician and support service providers
b. Outcomes evaluation to measure results
c. Patient self-management education
d. Measuring only post-intervention design
D
Why is it advantageous to run
pilot programs prior to implementing a disease management program? )
a. Allows developers to test interventions before investing in a population inclusive program
b. Ensures exclusive contractual arrangements are made between the patient and family
c. Ensures 100 percent of the success of the program
d. Confirms 100 percent predictability of outcomes
A
Disease management programs
development is based on all of the following, except:
a. Knowledge of the condition
b. Random population samples
c. Alignment of incentive
d. Focus on prevention
B
The purpose of the Clinical Value
Compass includes all of the following, except:
a. Members’ satisfaction
b. Cost of care
c. Non functional family status
d. Clinical Status
C
CM is data driven and outcome
focused.
True
False
true
Data collection is an important
function of population health case management because:

a. It protects the case manager from malpractice actions
b. All files must be complete in order to be reimbursed
c. Administrators rely on the data when planning annual budgets
d. It has a central role in quality improvement and outcomes research

D
Key differences between casemanagement and disease management include:
a. Individual vs. group focus
b. Operates across care settings vs. operates across a full disease continum
c. Episodic services vs. continuous services
d. All of the above
D
Using the “Stages of Change”
model (Zimmerman 2000), which stage describes people who are ambivalent about change?
a. Pre-contemplation Stage
b. Contemplation Stage
c. Preparation Stage
d. Action Stage
B
Cost, quality, and access
pressures in health care have provided an impetus for case management and managed care.
True
False
true
The most basic concepts
inherently linked to disease management include all of the following, except:
a. Critical pathways
b. Case management
c. Marketing guidelines
d. Clinical practice guidelines
C
What is the most prevalent type of electronic health care data?
a. System data
b. Claims data
c. DOS data
d. Nursing Data
B
According to Trella (1996), it is
necessary to integrate three key components of a health care system into a chronic care network. Which of the following is NOT one of the three key components?
a. Integrated finance mechanism
b. Integrated Reform initiatives
c. Integrated information systems
d. Integrated care management
B
Chronic Illness requires ongoing
guidance and support from a disease case manager.
True
False
true
Which statement is correct
surrounding the continuum of care?
a. A true continuum of care can be achieved only through the availability of a wide range of delivery sites and services.
b. An individuals’ course of treatment will only be effectively determined if, assigned to, a disease manager at the onset of the disease.
c. The continuum of services must be comprehensive and not change regardless of any changes in the patients needs.
d. The course of treatment is adversely affected regardless of the point at which a patient enters the continuum of care.
A
A totally integrated information
system across the entire continuum of care does exist.
True
False
false
An essential element in
maintaining an effective continuum of care system includes:
a. Comprehensive plans of care that are limited to the patients immediate care needs
b. Written plans of care addressing only short-term care goals
c. Frequent monitoring and documentation of patient progress
d. Disregard of all financial consideration
C
The leading causes of death in
the United States include all, except:
a. Diabetes
b. Stroke
c. Cancer
d. Heart disease
A
In order to work successfully with
chronically ill patients, the physician should consider:

a. Treatment for the disease based on a recipe of standard care prescribed globally for a disease
b. Communicating clearly with the patient about their specific protocol for effective management
c. Communicating only with the patient effectively about their care needs, disregarding the patient’s ideas and knowledge
d. None of the above

B
Level____ of intensity of care
describes the following disease complexity: Primary care treatment with patient education and support for management.

a. 1
b. 2
c. 3
d. 4

B
To ensure compliance of
medication, which statement is correct?

a. Pharmacy refill records may be monitored
b. Ask the patient if medications are taken
c. Remove the clients’ medications from the bottle and ensure they are the same color and shape
d. Every 90 days, have a family member count the number of pills remaining in the bottle

A
The most common intervention
strategies case managers may use to encourage clients’ adherence:
a. Promote adherence at the onset of treatment
b. Utilize interventions such as contracting
c. Involve the family in educational efforts
d. All of the above
D
Lifestyle management is a component of:
a. Disability management
b. Holistic health management
c. Case management
d. Population health management
D
(Chapters 1 and 5, Population Health Management)
What techniques can be used to motivate patients’ compliance with the management plan?
a. Enhance the individuals understanding of the health and psycho/social benefits of complying with the treatment plan
b. Fortify the individual’s confidence in being able to achieve the disease management plan goals
c. Enlist the support of significant others
d. All of the above
D
Some of the most common barriers in maintaining successful disease management programs include all of the following except:
a. A patient whose health is consistent with coordinated services
b. When multiple agencies and providers are involved
c. Some providers may have difficulty supplying the necessary care and treatment
d. The party responsible for the expense of disease management is unclear
A
(Unit 1, Frequently Asked Questions)
The goal of ______________ is to
prevent exacerbation of illness and avoid or delay the onset of an acute disease.
a. Disease Management
b. Managed Care
c. Disability Legislation
d. Active Management
A
(Unit 1, Frequently Asked Questions)
This organization represents the disease management community.
a. AAHP
b. ARP
c. DMAA
d. DM
C
(Chapter 22, Leadership and Nursing Care Management)
Major strategies of disease
management programs use which of following components to improve overall health?
a. Routine reporting and feedback loop
b. Outcome evaluations to measure results
c. Evidence-based practice guidelines
d. All of the above
D
(Chapter 22, Leadership and Nursing Care Management)
Disease management efforts
usually target:

a. People with chronic conditions
b. Conditions for which long-term management can minimize or prevent complications
c. Chronic conditions that can be managed better to reduce the need for medical care
d. All of the above

D
(Chapter 22, Leadership and Nursing Care Management
Population health improvement
relies on which key component?

a. Patient-centric health management goals
b. Accountable clinical indicators
c. Government funding of essential basic services
d. Stair step programs that build on self-efficacy skills

A
(Chapter 22, Leadership and Nursing Care Management)
Disease management and case
management programs are:
a. Distinct and separate strategies, but with overlap as both are interventions designed to coordinate care for better outcomes.
b. Similar in approach to diseases and the terms may be used interchangeably
c. Different because only disease management looks at the scope of the continuum of care
d. All of the above
A
(Chapter 22, Leadership and Nursing Care Management)
The Disease Management
Association of America (DMAA) is now known as:

a. DMAA: The Care Continuum Alliance
b. Management Alliance of America
c. American Association of Disease Managers
d. Population Health Management Association

A
Chapter 22, Leadership and Nursing Care Management)
Disease
The focus of Disease Management is:
a. Targeting individuals who are at high risk for specific diseases
b. Provide extensive interventions about prevention
c. Include prevention and well-being interventions for populations served
d. All of the above
D
(Chapter 6, Nursing Case Management)
Why are disease management pilot programs helpful?
a. Allow test runs of the interventions
b. Assist prior to investing in a population-inclusive program
c. Allow for perceptions of the program participants and health care providers
d. All of the above
D
Chapter 6, Nursing Case Management)
Case management refers to which
of the following?

a. Efforts to prevent disease or complications in groups of people with the same condition
b. Client-focused strategies to coordinate and integrate care
c. Well defined program objectives to reduce disability
d. Population-based care management

B
(Chapter 22, Leadership and Nursing Care Management)
A Disease Management program is based on which of the following?
a. Knowledge of condition
b. Identification of the population
c. Development of information system
d. All of the above
D
(Chapter 6, Nursing Case Management)
Key differences between case management and disease management include all of the following, except:
a. Balancing cost vs. quality
b. Individualized planning vs. adherence to practice guidelines
c. Recovery or remediation of problems vs. prevention of complications or exacerbations
d. Individual vs. aggregate focus
A
(Chapter 22, Leadership and Nursing Care Management)
Case management is sometimes
called by other names, EXCEPT:
a. Evidence-based practice manager
b. Care management
c. Outcomes management
d.Clinical resource management
A
(Chapter 22, Leadership and Nursing Care Management)
Which step within the disease
management system describes the intervention based on academic research and best practice?
a. Implementing the disease management plan
b. Development of clinical pathways and disease management interventions
c. Determination of benefits
d. Health assessment and evaluation of the identified population
B
(Unit 2, Frequently Asked Questions)
The following concepts are inherently linked to disease management, except:
a. Case management
b. Clinical practice guidelines
c. Availability of DME suppliers
d. Critical pathways
C
(Unit 2, Frequently Asked Questions)
A cost-benefit analysis for disease management is based upon:
a. Population-based case management
b. Acuity levels
c. Ability to decrease the severity and to prevent the progression of the disease
d. All of the above
D
(Unit 2, Frequently Asked Questions)
Typically, health care data
utilizing claims data is formatted by which of the following?

a. Pharmaceutical Claims using national Drug codes
b. Professional Claims using Health Care Financing Administration format
c. Hospital inpatient utilizing uniform billing formats
d. All of the above

D
Typically, health care data utilizing claims data is formatted by which of the following?
Student Answer: Pharmaceutical Claims using national Drug codes
Professional Claims using Health Care Financing Administration format
Hospital inpatient utilizing uniform billing formats
CORRECT All of the above (Unit 2, Frequently Asked Questions
Which statement surrounding Disease Management is incorrect?
a. A valuable program does not necessarily address the underlying needs
b. The program should be based on the underlying needs
c. Throughout the process of design and implementation of the program, the needs are continually addressed
d. The reason for the existence of disease management programs should be the basis for design and implementation
A
(Chapter 20, CMSA Core Curriculum for Case Managers)
There are several steps in the disease management process. Which step defines the core elements?
a. First Step
b. Second Step
c. Third Step
d. Fourth Step
C
(Chapter 20, CMSA Core Curriculum for Case Managers)
Which statement describes a benefit in conducting a small pilot program?
a. Helps the team identify difficulties
b. Helps develop solutions
c. Refines all aspects of the program before larger numbers of patients are involved
d. All of the above
D
(Chapter 20, CMSA Core Curriculum for Case Managers)
What outcomes can be evaluated from a small pilot program?
Clinical
Quality of Life
Financial
Members Satisfaction
All of the above
None of the above
All of the above (Chapter 20, CMSA Core Curriculum for Case Managers)
Outcomes of Disease Management Programs may include:
a. Improvement in disease specific clinical outcomes
b. Decreased patient satisfaction
c. Reactive approach to care deliveries
d. Limited access to health care services
A improvement in disease specific clinical outcomes (Chapter 20, CMSA Core Curriculum for Case Managers)
What are the barriers to a
successful disease management program?
System Barriers
Provider Barriers
Economic Barriers
All of the above
All of the above (CMSA Core Curriculum for Case Managers)
What are the major program
outcomes desired from population health management programs?
a. Reducing disability and b. increasing employee productivity
b. Health and wellness and controlling out-of-pocket costs
c. Improved clinical outcomes and efficient use of time
d. All of the above
D
(Chapter 3, Population Health Management)
Data sources for identifying participants in population health management programs include:
a. Employer data
b. Health plan insurance membership information
c. Utilization information
d. All of the above
D
(Chapter 4, Population Health Management)
In general, what components of
an organization must be considered when creating disease management strategies?
a. Culture of the organization
b. Structure of the organization
c. Skills of the organization
d.All of the above
D
(Unit 3, Frequently Asked Questions)
The four levels of the disease management process that can be assessed and evaluated include:
a. National
b. Organizational
c. Provider and Patient
d. All of the above
D
(Unit 3, Frequently Asked Questions
Page 4)
Which statement is correct surrounding an integrated information system?
a. A totally integrated information system across the entire continuum of care does not exist.
b. Integrated information systems are not valuable to a case manager because only paper files are effective in collecting reports and services provided.
c. Integrated information systems would eliminate human error and incomplete or inaccurate data.
d. A paper trail system is often an efficient and effective method of transferring information.
A
(Reading Assignment: “Disease Management for Specific Chronic Conditions”)
Components of an integrated chronic care network include all, EXCEPT:
a. Integrated Financing Mechanism
b. Integrated Reporting System
c. Integrated Information System
d. Integrated Care Management
B
(Reading Assignment: “Disease Management for Specific Chronic Conditions”)
Brueckner and Glover (1994) assert that essential elements in maintaining an effective continuum of care system include:
a. Frequent and honest communication among service providers, payers, and patients
b. Comprehensive plans of care that address the patients future needs, with frequent evaluation of progress and modification as necessary
c. Frequent monitoring and documentation of patient progress
d. All of the above
D
(Reading Assignment: “Disease Management for Specific Chronic Conditions)
Which level of intensity of care describes the following disease complexity: Specialty level consultation in the primary care setting for patients with complicated disease.
a. Level 1
b. Level 2
c. Level 3
d. Level 4
C
(Reading Assignment: “Management of Chronic Disease by Patients”)
Which of the following is found to be most relevant in adherence to medical regimens?
a. The complexity of the regimen such as the number of times per day is carried out and its behavioral components and duration
b. Adherence to medical regimens that involve short term, but complex regimens.
c. Adherence to medical regimens that include complex regimens, but poor patient satisfaction
d. None of the above
A
(Assignment: “Adherence to Prescribed Medical Regimes”)
The primary consequences of non-adherence or poor adherence to prescribed medical regimens include:
a. Increased cost of care over the course of the illness
b. Morbidity
c. Development of drug-resistant strains or organisms
d. All of the above
D
(Reading Assignment:” Adherence to Prescribed Medical Regimes)
The most common intervention strategies case managers may use to encourage clients’ adherence include all, except:
a. Promote adherence at the onset of treatment
b. Utilize interventions such as contracting
c. Involve the family in educational efforts
d. Contact the patient twice daily to ensure medications are taken on time
D
(Reading Assignment: “Adherence to Prescribed Medical Regimes”)
Consequences for poor adherence to medical regiments include:
a. Increased cost of care over the course of the illness
b. Morbidity
c. Unnecessary complications
d. All of the above
D
(Reading Assignment: “Adherence to Prescribed Medical Regimes”)
Characteristics of individuals who
are most likely to adhere to prescription drug recommendations include all, except:
a. Understand the purpose of the drug
b. Believe in the efficacy of the medication
c. Have a poor relationship with their physician/clinician
d. Ask questions and adhere to prescription drug recommendations
C
(Reading Assignment: “Adherence to Prescribed Medical Regimes”)
Poor adherence to medical regimens is believed to be greatest among individuals who:
a. Have short term conditions
b. Have simple conditions
c. Take one medication daily
d. Have chronic conditions with long-term complex regimens
D
(Reading Assignment: “Adherence to Prescribed Medical Regimes”
Page 5)
What is meant by demand management strategies?
a. Medicine without charge
b. Medical standard of practice
c. Services designed to modify or improve consumer demand for care
d. Medical practice guidelines
C
(Chapter 6, Population Health Management)
All of the following are risks of
demand management strategies EXCEPT:

a. Reduction in service provision that is not clinically appropriate
b. Patients receive excessive services
c. Inappropriate advice or information is given to patients
d. The goal may be cost reduction instead of guiding appropriate care

B
(Chapter 6, Population Health
Management)
Which statement is correct about
the benefits to employers of demand management?
a. There is increased productivity
b. There is increased employee retention
c. There is improved employee morale
d. All of the above.
D
(Chapter 6, Population Health Management)
The future of disease management is that:
a. It will likely disappear as disease prevention becomes more successful
b. It will create more concerns about privacy and confidentiality as data is collected and used
c. It will become part of the usual care process for care delivery
d. All of the above
C
(Chapter 7, Population Health Management)
Catastrophic care management is:
a. A specialized type of disease management
b. Targeted for rare illnesses
c. Targeted for high-severity, complex cases
d. All of the above
D
(Chapter 8, Population Health Management)
Catastrophic case management is
used for:
a. High prevalence diseases with predictable outcomes
b. Only those patients with access to major tertiary centers that provide multidisciplinary services
c. Situations where poor management of common problems has led to life-threatening co-morbidities
d. Cases with a high rate of variability among current practice patterns and outcomes that take a long period to achieve
D
(Chapter 8, Population Health Management)
Which statement is correct?
a. The Americans with Disabilities Act requires employers to accommodate all disabilities.
b. The Americans with Disabilities Act defines disability as physical of mental impairment that substantially limits one or more major life activities.
c. Work-related disability results in lost work time in the majority of cases.
d. The most common chronic condition among workers is asthma.
B
(Chapter 9, Population Health Management)
Nonmedical factors that influence the length of disability among employees include:
a. Job dissatisfaction
b. Litigation
c. Interpersonal relationships
d. All of the above
D
(Chapter 9, Population Health Management)
Integrating population health management programs into existing organizations:
a. May result in turf issues
b. May result in rivalry with existing programs
c. Creates challenges for hiring the right personnel
d. All of the above
D
(Chapter 12, Population Health Management)
Which statement is correct
regarding case managers in population health management programs?
a. Case managers must coordinate with care providers.
b. Case managers spend the majority of their time doing data collection and file review.
c. Case managers can lose clinical expertise because they are not doing hands-on care.
d. Case managers are often viewed as trying to deny access to care.
A
(Chapter 12, Population Health Management)
According to Trella (1996), it is
necessary to integrate three key components of a health care system into a chronic care network. Which of the following is NOT one of the three key components?

a. Integrated finance mechanism
b. Integrated Reform initiatives
c. Integrated information systems
d. Integrated care management

B
Chronic Illness requires ongoing
guidance and support from a disease case manager.
True
False
true
Which statement is correct
surrounding the continuum of care?
a. A true continuum of care can be achieved only through the availability of a wide range of delivery sites and services.
b. An individuals’ course of treatment will only be effectively determined if, assigned to, a disease manager at the onset of the disease.
c. The continuum of services must be comprehensive and not change regardless of any changes in the patients needs.
d. The course of treatment is adversely affected regardless of the point at which a patient enters the continuum of care.
A
A totally integrated information
system across the entire continuum of care does exist.
True
False
false
. An essential element in
maintaining an effective continuum of care system includes:
a. Comprehensive plans of care that are limited to the patients immediate care needs
b. Written plans of care addressing only short-term care goals
c. Frequent monitoring and documentation of patient progress
d. Disregard of all financial consideration
C
In order to work successfully with
chronically ill patients, the physician should consider:
a. Treatment for the disease based on a recipe of standard care prescribed globally for a disease
b. Communicating clearly with the patient about their specific protocol for effective management
c. Communicating only with the patient effectively about their care needs, disregarding the patient’s ideas and knowledge
d. None of the above
B
Level____ of intensity of care
describes the following disease complexity: Primary care treatment with patient education and support for management. a. 1
b. 2
c. 3
d. 4
B
To ensure compliance of
medication, which statement is correct?
a. Pharmacy refill records may be monitored
b. Ask the patient if medications are taken
c. Remove the clients’ medications from the bottle and ensure they are the same color and shape
d. Every 90 days, have a family member count the number of pills remaining in the bottle
A
The most common intervention
strategies case managers may use to encourage clients’ adherence:
a. Promote adherence at the onset of treatment
b. Utilize interventions such as contracting
c. Involve the family in educational efforts
d. All of the above
D