The Business of Medicine: Foundational Information Not Taught in Residency – Post Test

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Question 1 of 5

1. Question
1. Which statement is false regarding a DRG? A DRG …
- a. Is a measure to show the “degree of sickness” of a condition with hospitalized patients
- b. Can be modified by noting comorbid conditions and comorbidities
- c. Is a payment category that is used for the purpose of reimbursing hospitals for a fixed fee regardless of the actual costs incurred for a patient’s care
- d. Is applied on both inpatient and outpatient services
Question 2 of 5

2. Question
2. True comments related to the “risk score” in clinical documentation include all EXCEPT:
- a. Higher scores indicate a higher clinical “risk” and usually a projected higher “cost” of care
- b. It is captured when a diagnosis is added to the claim billed for an office visit
- c. The risk score for type 2 diabetes is the same as type 2 diabetes with nephropathy
- d. Lower risk score capture may negatively impact revenues allotted to the health plan to be used in patient care delivery
Question 3 of 5

3. Question
3. The Stars Quality Program measures focus on all of these EXCEPT
- a. Breast and colon cancer screening
- b. Acute condition management (strep pharyngitis)
- c. Diabetes care related to A1c control
- d. Blood pressure control
Question 4 of 5

4. Question
4. The Medicare Part B program
- a. Covers physician payment and other ambulatory services
- b. Is free to persons who paid enough in payroll taxes over time
- c. Is the program where Medicare Advantage is defined
- d. Covers prescription drug costs outside of the donut hole
Question 5 of 5

5. Question
5. To have success in the business of hospital based medicine, one must
- a. Manage the DRG with the right diagnoses, right severity of illness
- b. Manage the LOS, striving for clinically correct management and a safe discharge
- c. Manage the cost of care ordering the right test at the right time for the right situation
- d. All of the above

The Business of Medicine: Foundational Information Not Taught in Residency – Post Test

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