AHIP Exam AHM-530 Topic 3 Question 74 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 74
Topic #: 3

One true statement about the compensation arrangement known as the case rate system is that, under this system,

AProviders stand to gain or lose based on the number and types of treatments used for each case

BProviders have no incentives to take an active role in managing cost and utilization

CPayors cannot adjust standard case rates to reflect the severity of the patient's condition or complications that arise from multiple medical problems

DPayors have the opportunity to benefit from the provider's cost savings

Show Suggested Answer

Suggested Answer: A

by Lashon at Aug 31, 2023, 03:01 AM

Limited Time Offer

25%

Off

Get Premium AHM-530 Questions as Interactive Web-Based Practice Test or PDF

Contribute your Thoughts:

Submit Cancel

Chi

1 months ago

Hey, at least with the case rate system, the providers can't charge you an arm and a leg. They have to keep a tight lid on those costs, or it's case closed for them!

upvoted 0 times

Noemi

18 days ago

That's true! Providers really have to be careful with their costs under the case rate system.

upvoted 0 times

...

Bettye

25 days ago

C) Payors cannot adjust standard case rates to reflect the severity of the patient's condition or complications that arise from multiple medical problems

upvoted 0 times

...

Shawna

1 months ago

A) Providers stand to gain or lose based on the number and types of treatments used for each case

upvoted 0 times

...

Scot

2 months ago

Option D is the winning answer. The provider's cost savings directly benefit the payor under a case rate arrangement. It's a win-win!

upvoted 0 times

Bette

1 months ago

Having the opportunity for payors to benefit from cost savings is a smart incentive for providers to manage costs efficiently.

upvoted 0 times

...

Cheryl

1 months ago

It's great that providers and payors can both benefit from cost savings in this system.

upvoted 0 times

...

Jess

1 months ago

I agree, option D is definitely a win-win for both parties.

upvoted 0 times

...

Hershel

2 months ago

Option C is clearly wrong. Payors can absolutely adjust case rates to account for patient complexity and complications. That's kind of the whole point of the system.

upvoted 0 times

Temeka

18 days ago

Exactly, option C is definitely incorrect. Payors can definitely adjust case rates based on patient complexity.

upvoted 0 times

...

Daryl

25 days ago

D) Payors have the opportunity to benefit from the provider's cost savings

upvoted 0 times

...

Daren

30 days ago

B) Providers have no incentives to take an active role in managing cost and utilization

upvoted 0 times

...

Raymon

1 months ago

A) Providers stand to gain or lose based on the number and types of treatments used for each case

upvoted 0 times

...

Tracie

2 months ago

But A makes sense because providers are directly impacted by the treatments used.

upvoted 0 times

...

Leoma

2 months ago

I'm not sure about the 'no incentives' claim in Option B. Providers may not have as much control as in a fee-for-service model, but they still have an interest in keeping costs down.

upvoted 0 times

Misty

1 months ago

I agree, providers still have an interest in managing costs under the case rate system.

upvoted 0 times

...

Gussie

1 months ago

A) Providers stand to gain or lose based on the number and types of treatments used for each case

upvoted 0 times

...

Janella

2 months ago

Option A seems to be the most accurate description of the case rate system. Providers definitely have an incentive to manage costs and utilization under this arrangement.

upvoted 0 times

...

Alana

2 months ago

I disagree, I believe it's D.

upvoted 0 times

...

Tracie

3 months ago

I think the answer is A.

upvoted 0 times

...