CCM Quality Improvement & Outcomes Management Flashcards
6 cards from real CCM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CCM Quality Improvement & Outcomes Management flashcards as text
Which organization's standards does URAC accreditation for health care management programs primarily validate?
Answer: Operational and quality standards for managed care and case management organizations
URAC accreditation validates that health management and case management organizations meet rigorous operational, quality, and consumer protection standards.
A CCM program sets a benchmark of reducing 30-day hospital readmissions by 15% within one year. This is an example of a:
Answer: SMART outcome goal
A SMART goal is Specific, Measurable, Achievable, Relevant, and Time-bound; reducing readmissions by 15% in one year meets all these criteria.
In Donabedian's quality model, which component examines the physical and organizational settings in which care is delivered?
Answer: Structure
Donabedian's Structure component encompasses the settings, qualifications of providers, and organizational resources available for delivering care.
A CCM monitors a client population's average HbA1c levels quarterly and observes a sustained decrease over 12 months. This represents improvement in which type of measure?
Answer: Outcome measure
Tracking HbA1c levels as a health status indicator reflects an outcome measure, showing the clinical result of diabetes management interventions.
The Triple Aim framework in health care improvement focuses on three simultaneous goals. Which of the following correctly identifies all three?
Answer: Population health, patient experience, and per capita cost reduction
The IHI Triple Aim targets improving population health, enhancing the patient experience, and reducing per capita health care costs simultaneously.
A CCM is reviewing quality data and notices a sudden spike in medication errors following a staffing change. In quality improvement terms, this spike represents:
Answer: Special cause variation
Special cause variation is an unpredictable, assignable change in a process—such as a staffing change—that falls outside normal variation patterns and requires investigation.