HAC HAC Risk Stratification & Care Management Analytics 2

Question 1

Social determinants of health (SDOH) data are increasingly incorporated into risk stratification models because:

Accepted Answer

Non-clinical factors like housing instability and food insecurity independently predict poor health outcomes and utilization

Answer

Research consistently shows that social factors such as food insecurity, housing, and transportation barriers are strong independent predictors of health outcomes.

Question 2

What is the purpose of a 'propensity score' in healthcare program evaluation analytics?

Accepted Answer

To statistically balance comparison groups in observational studies to reduce selection bias when measuring program impact

Answer

Propensity scoring estimates the probability that a subject receives a treatment given observed covariates, enabling fairer comparison between intervention and control groups.

Question 3

Which utilization management metric measures the proportion of inpatient admissions that were potentially avoidable through better outpatient or preventive care?

Accepted Answer

Ambulatory care sensitive condition (ACSC) admission rate

Answer

ACSC admission rates track hospitalizations for conditions like uncontrolled diabetes or asthma that good outpatient care should prevent, serving as a proxy for care management effectiveness.

Question 4

In transitional care analytics, what does a high '30-day post-discharge ED visit rate' typically signal?

Accepted Answer

Gaps in discharge planning, medication reconciliation, or outpatient follow-up that leave patients vulnerable after leaving the hospital

Answer

Frequent ED visits shortly after discharge indicate that patients' needs are not being adequately managed in the community, often due to poor care transition processes.

Question 5

A risk stratification model has high sensitivity but low specificity. What does this mean for care management resource allocation?

Accepted Answer

It catches most truly high-risk patients but also flags many low-risk patients, leading to inefficient use of care management resources

Answer

High sensitivity ensures few high-risk patients are missed, but low specificity means many low-risk patients are also flagged, diluting care management resources across unnecessary enrollments.

(HAC) Healthcare Analytics Certification Practice Test

(HAC) Healthcare Analytics Certification Practice Test

HAC HAC Risk Stratification & Care Management Analytics 2