CCM Operational Excellence & Efficiency 3

Question 1

In care management operations, a 'warm handoff' refers to:

Accepted Answer

A direct introduction between a patient and their new care manager or provider

Answer

A warm handoff is a real-time, personal introduction that facilitates relationship transfer between care team members to reduce gaps in care.

Question 2

A care management director wants to reduce care manager burnout. Which operational change has the strongest evidence for sustainability?

Accepted Answer

Implementing defined caseload caps based on acuity-adjusted ratios

Answer

Acuity-adjusted caseload caps ensure workload is distributed equitably and sustainably, addressing a primary structural cause of burnout.

Question 3

Which element is MOST critical to include in a care management program's operational dashboard for weekly team review?

Accepted Answer

Caseload size, contact attempt rates, and enrollment conversion rates

Answer

Operational dashboards should track activity metrics (caseload, contact attempts) and conversion rates that reflect the program's ability to engage and enroll members.

Question 4

The Plan-Do-Study-Act (PDSA) cycle is used in care management to:

Accepted Answer

Test small-scale changes and evaluate their impact before full implementation

Answer

The PDSA cycle is a rapid-cycle improvement methodology that tests changes on a small scale, studies results, and acts on learnings before broader rollout.

Question 5

A health plan's care management program has an opt-out enrollment model. The primary operational advantage of this approach is:

Accepted Answer

It maximizes program enrollment rates, particularly among high-risk members

Answer

Opt-out enrollment (where members are automatically enrolled unless they decline) consistently achieves higher participation rates, especially among members who would benefit most.

(CCM) Certified Care Management Professional Practice Test

(CCM) Certified Care Management Professional Practice Test

CCM Operational Excellence & Efficiency 3