CCM Industry Trends & Emerging Technologies 3 — Questions and Answers
Question 1: A health system deploys an AI algorithm to prioritize care management outreach, but the algorithm was trained predominantly on data from insured white males. This MOST likely results in:
- Improved efficiency for all populations equally
- Algorithmic bias that under-identifies high-risk minority patients (Correct answer)
- Overfitting to rare disease presentations
- Reduced false-positive rates across all demographics
Correct answer: Algorithmic bias that under-identifies high-risk minority patients
Algorithms trained on non-representative datasets perpetuate existing health disparities by systematically under-scoring risk in underrepresented groups.
Question 2: Which telehealth policy change made permanent after the COVID-19 public health emergency most expanded access for Medicare beneficiaries?
- Requiring all telehealth visits to occur in rural originating sites
- Allowing audio-only telephone visits for behavioral health services (Correct answer)
- Mandating in-person visits before any telehealth service
- Restricting telehealth to federally qualified health centers
Correct answer: Allowing audio-only telephone visits for behavioral health services
Permanent authorization of audio-only telephone visits for behavioral health expanded access for Medicare beneficiaries lacking video technology or broadband.
Question 3: In population health management, a 'hot-spotting' strategy focuses resources on:
- Patients with the best adherence records to optimize outcomes
- Geographic areas or individuals with disproportionately high utilization and costs (Correct answer)
- High-volume specialty procedures for cost reduction
- Preventive screenings for low-risk populations
Correct answer: Geographic areas or individuals with disproportionately high utilization and costs
Hot-spotting targets the small percentage of patients or communities responsible for the majority of healthcare costs and emergency utilization.
Question 4: A CCM is evaluating a digital therapeutics (DTx) application for patients with type 2 diabetes. Which regulatory body in the US oversees software-based medical devices intended to treat disease?
- Centers for Medicare & Medicaid Services (CMS)
- Food and Drug Administration (FDA) (Correct answer)
- Office for Civil Rights (OCR)
- Agency for Healthcare Research and Quality (AHRQ)
Correct answer: Food and Drug Administration (FDA)
The FDA regulates software as a medical device (SaMD), including prescription digital therapeutics intended to diagnose, treat, or manage a disease.
Question 5: Which emerging model of care delivery uses a multidisciplinary team, often including community health workers, to address both clinical and social needs of high-risk patients in their homes?
- Direct primary care subscription model
- Intensive outpatient psychiatric program
- Complex care or 'super-utilizer' home-based program (Correct answer)
- Disease-specific specialty medical home
Correct answer: Complex care or 'super-utilizer' home-based program
Complex care programs for super-utilizers embed community health workers and clinical staff to manage medical and social needs, reducing emergency department visits.
Question 6: What does the term 'interoperability' mean in the context of health information technology?
- The ability of a health system to operate across multiple hospital campuses
- The capacity of different health IT systems to exchange and use data seamlessly (Correct answer)
- A federal requirement to standardize physician credentialing
- Compatibility of medical devices with hospital power systems
Correct answer: The capacity of different health IT systems to exchange and use data seamlessly
Health IT interoperability refers to the ability of disparate systems to exchange, interpret, and act on shared electronic health information.
Question 7: Which trend describes the shift of routine and elective procedures from inpatient hospitals to ambulatory surgery centers (ASCs) and outpatient settings?
- Deinstitutionalization of mental health services
- Site-of-care optimization or migration (Correct answer)
- Retail health clinic expansion
- Integrated delivery network consolidation
Correct answer: Site-of-care optimization or migration
Site-of-care optimization moves appropriate procedures to lower-cost ambulatory settings, reducing total cost of care while maintaining safety and quality.
CCM Industry Trends & Emerging Technologies 3
A health system deploys an AI algorithm to prioritize care management outreach, but the algorithm was trained predominantly on data from insured white males.
This MOST likely results in: