Buttaro: Primary Care, A Collaborative Practice, 5

th Ed.

Primary Care : A Collaborative Practice, 5th Edition

Terry Buttaro, JoAnn Trybulski, Patricia Polgar-Bailey Joanne Sandberg-Cook

Chapter 1: The Evolving Landscape of Collaborative

PracticeTest Bank

Multiple Choice

1. Which assessments of care providers are performed as part of the Value Based

Purchasinginitiative?

Select all that apply.

a. Appraising costs per case of care for Medicare patients

b. Assessing patients’ satisfaction with hospital care

c. Evaluating available evidence to guide clinical care guidelines

d. Monitoring mortality rates of all patients with pneumonia

e. Requiring advanced IT standards and minimum cash reserves

ANS: A, B, D

Value Based Purchasing looks at five domain areas of processes of care, including

efficiency of care (cost per case), experience of care (patient satisfaction measures), and

outcomes of care (mortality rates for certain conditions. Evaluation of evidence to guide

clinical care is part of evidence-based practice. The requirements for IT standards and

financial status are part of Accountable Care Organization standards. REF: Value Based

Purchasing

2. What was an important finding of the Advisory Board survey of 2014 about

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Test Bank 2

primary carepreferences of patients?

a. Associations with area hospitals

b. Costs of ambulatory care

c. Ease of access to care

d. The ratio of providers to patients

ANS: C

As part of the 2014 survey, the Advisory Board learned that patients desired 24/7 access

to care, walk-in settings and the ability to be seen within 30 minutes, and care that is close

to home. Associations with hospitals, costs of care, and the ratio of providers to patients

were not part of these results. REF: The New Look of Primary Care

3. A small, rural hospital is part of an Accountable Care Organization (ACO) and is

designatedas a Level 1 ACO. What is part of this designation?

a. Bonuses based on achievement of benchmarks

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Buttaro: Primary Care, A Collaborative Practice, 5

th Ed.

b. Care coordination for chronic diseases

c. Standards for minimum cash reserves

d. Strict requirements for financial reporting

ANS: A

A Level 1 ACO has the least amount of financial risk and requirements, but receives shared

savings bonuses based on achievement of benchmarks for quality measures and

expenditures. Care coordination and minimum cash reserves standards are part of Level

2 ACO requirements. Level 3 ACOs have strict requirements for financial reporting. REF:

Accountable Care Organizations

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Test Bank 2

Chapter 2: Transitional

CareTest Bank

Multiple Choice

1. To reduce adverse events associated with care transitions, the Centers for

Medicare andMedicaid Service have implemented which policy?

a. Mandates for communication among primary caregivers and hospitalists

b. Penalties for failure to perform medication reconciliations at time of discharge

c. Reduction of payments for patients readmitted within 30 days after discharge

d. Requirements for written discharge instructions for patients and caregivers

ANS: C

As a component of the Affordable Care Act, the Centers for Medicare and Medicaid Service

developed the Readmissions Reduction Program reducing payments for certain patients

readmitted within 30 days of discharge. The CMS did not mandate communication,

institute penalties for failure to perform medication reconciliations, or require written

discharge instructions. REF: Transitional Care

2. According to Naylor’s transitional care model, which intervention has resulted in

lower costsand fewer rehospitalizations in high-risk older patients?

a. Coordination of post-hospital care by advanced practice nurses

b. Frequent post-hospital clinic visits with a primary care provider

c. Inclusion of extended family members in the outpatient plan of care

d. Telephone follow up by the pharmacist to assess medication compliance

ANS: A

Naylor’s transitional care model provided evidence that high risk older patients who had

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