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

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Scot

4 hours 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!

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Hershel

3 days 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.

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Tracie

10 days ago

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

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Leoma

11 days 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.

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Janella

12 days 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.

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Alana

12 days ago

I disagree, I believe it's D.

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Tracie

22 days ago

I think the answer is A.

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