CCM General 3

Question 1

When performing a comprehensive needs assessment, which domain is MOST critical for a case manager to evaluate in a client newly diagnosed with a chronic illness?

Accepted Answer

Psychosocial and support system factors

Answer

Psychosocial factors including social support, mental health, and coping capacity are central to successful chronic disease management.

Question 2

Which payment model reimburses a fixed amount per patient per month regardless of services utilized?

Accepted Answer

Capitation

Answer

Capitation pays a fixed monthly amount per enrolled member, incentivizing preventive care and efficient resource use.

Question 3

A case manager identifies that a client's home environment poses fall risks. The BEST next step is to:

Accepted Answer

Refer for a home safety evaluation by an occupational therapist

Answer

An occupational therapist home safety evaluation identifies specific hazards and recommends targeted modifications to reduce fall risk.

Question 4

Which concept describes the ability of a healthcare system to provide care that does not vary in quality because of personal characteristics such as gender, ethnicity, or socioeconomic status?

Accepted Answer

Health equity

Answer

Health equity means every person has a fair opportunity to attain their highest level of health regardless of social determinants.

Question 5

A Milliman Care Guideline (MCG) is BEST described as:

Accepted Answer

An evidence-based clinical criteria tool used in utilization management

Answer

MCG guidelines are evidence-based criteria used to determine appropriate level of care and length of stay during utilization review.

CCM - Certified Case Manager Exam Practice Test

CCM - Certified Case Manager Exam Practice Test

CCM General 3