ACMPE ACMPE Quality Improvement and Compliance 1 — Questions and Answers
Question 1: Which quality improvement methodology uses the Plan-Do-Study-Act cycle to drive continuous improvement in a medical practice?
- PDSA cycle (Correct answer)
- Six Sigma DMAIC
- Lean 5S
- Root cause analysis
Correct answer: PDSA cycle
The PDSA (Plan-Do-Study-Act) cycle is a scientific method for iterative testing and improvement of healthcare processes.
Question 2: Which federal program penalizes hospitals and practices for excessive rates of preventable readmissions within 30 days?
- Hospital Readmissions Reduction Program (HRRP) (Correct answer)
- Value-Based Purchasing Program
- Merit-Based Incentive Payment System
- Meaningful Use Program
Correct answer: Hospital Readmissions Reduction Program (HRRP)
The HRRP reduces Medicare payments to hospitals with excess readmissions for specific conditions, incentivizing care coordination and follow-up.
Question 3: In healthcare quality measurement, what does the acronym HEDIS stand for?
- Healthcare Effectiveness Data and Information Set (Correct answer)
- Health Evidence and Data Integration System
- Healthcare Evaluation and Data Improvement Standards
- Health Equity Data and Information Survey
Correct answer: Healthcare Effectiveness Data and Information Set
HEDIS is a set of standardized performance measures developed by NCQA used by health plans to assess quality of care and services.
Question 4: Which accreditation organization reviews medical group practices against national standards for quality and safety in the United States?
- The Joint Commission (TJC)
- National Committee for Quality Assurance (NCQA)
- Utilization Review Accreditation Commission (URAC)
- Accreditation Association for Ambulatory Health Care (AAAHC) (Correct answer)
Correct answer: Accreditation Association for Ambulatory Health Care (AAAHC)
AAAHC is the primary accrediting body specifically for ambulatory healthcare organizations, including medical group practices.
Question 5: A medical practice implementing Lean methodology would primarily focus on eliminating which type of waste?
- Non-value-added activities (muda) (Correct answer)
- Staff overtime
- Supply inventory
- Documentation errors
Correct answer: Non-value-added activities (muda)
Lean identifies and eliminates 'muda' (waste)—activities that consume resources without adding value from the patient's perspective.
Question 6: Which compliance program element requires medical practices to establish a mechanism for employees to report suspected violations anonymously?
- Hotline or reporting system (Correct answer)
- Written policies and procedures
- Training and education
- Auditing and monitoring
Correct answer: Hotline or reporting system
An anonymous reporting mechanism (hotline) is one of the seven core elements of an effective compliance program per OIG guidelines.
ACMPE ACMPE Quality Improvement and Compliance 1
Which quality improvement methodology uses the Plan-Do-Study-Act cycle to drive continuous improvement in a medical practice?