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| Section | Weight | Objectives |
|---|---|---|
| Healthcare Environment | 26% | - Clinical and Business Terminology
|
| Systems Management | 27% | - Governance and Management
|
| Technology Environment | 27% | - Data and Information Management
|
| Related Topics | 20% | - Management and Leadership
|
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NEW QUESTION # 40
Which of the following ensures enhanced health care for the individual, improved health for the community population, and reduced per-capita cost?
Answer: C
Explanation:
The Triple Aim is the recognized strategic framework that explicitly targets three linked goals: (1) improving the individual experience of care (quality, safety, and satisfaction), (2) improving the health of populations , and (3) reducing the per-capita cost of healthcare . These three aims are designed to be pursued together because progress in one area can be undermined if the others are ignored-for example, improving patient experience without controlling cost may be unsustainable, while cost cutting that harms outcomes or experience fails the overall purpose of healthcare.
"Population health" (option B) is one component of the Triple Aim, but by itself it does not inherently ensure the other two aims (experience and per-capita cost). "Home health care" (option C) is a care setting/service model that may contribute to better outcomes and lower cost for certain groups, but it is not a comprehensive system-wide framework. "Tertiary care" (option D) refers to specialized, high-complexity services and likewise does not define a three-part improvement strategy.
Therefore, the option that best matches the combined goals in the question is Triple Aim .
NEW QUESTION # 41
Which of the following management activities is used to increase revenue, reduce days in accounts receivable, and reduce denied claims?
Answer: B
Explanation:
Revenue cycle management (RCM) is the end-to-end set of administrative and financial processes that manage patient service revenue from pre-registration and eligibility through coding, billing, claims submission, payment posting, denial management, and collections . Because RCM spans the full lifecycle, it directly targets the three outcomes named in the question. First, it increases revenue by improving charge capture, ensuring accurate clinical documentation and coding, and preventing underbilling. Second, it reduces days in accounts receivable (A/R) by streamlining claim submission, improving first-pass claim acceptance, accelerating payment posting, and prioritizing follow-up on unpaid claims. Third, it reduces denied claims by strengthening front-end verification (coverage, authorization), enforcing coding and medical necessity rules, and implementing denial analytics and appeal workflows to fix root causes.
"Revenue optimization" is a broader, less standardized term that may describe strategic improvement efforts but does not specifically represent the operational discipline that controls A/R and denials across the full cycle. "Revenue accounting" focuses on financial reporting and recognition rather than operational claim performance. "Expense management" targets cost reduction, not revenue realization. Therefore, RCM is the management activity that best fits all elements of the prompt.
NEW QUESTION # 42
Which of the following is a disadvantage to fully customizing a system to current organizational workflow?
Answer: D
Explanation:
Fully customizing a healthcare information system to match an organization's current workflow can create long-term operational risk because extensive customization often becomes tightly coupled to a specific vendor version and technical architecture. As vendors release upgrades, patches, and new features (often driven by patient-safety improvements, interoperability requirements, cybersecurity fixes, and regulatory updates), heavily customized environments typically require significant rework, retesting, and validation to ensure the custom components still function correctly. This can delay or effectively block timely upgrades, leaving the organization on older versions that may lack critical security patches or updated functionality.
While customization may reduce training needs in the short term by preserving familiar workflows (making option A an advantage), the upgrade burden is a classic downside: custom code, custom interfaces, and non- standard configurations increase maintenance complexity and can break during version changes. Over time, this can raise total cost of ownership and reduce agility, especially when the organization needs to adopt new standards, integrate additional systems, or support new care models. Therefore, the most direct and strategically significant disadvantage listed is the inability (or practical difficulty) of implementing future system upgrades, captured best by option C .
NEW QUESTION # 43
Digital health apps and fitness tracking devices can add patients' health data to their Electronic Health Records (EHR) by using a(n):
Answer: A
NEW QUESTION # 44
A project manager in a healthcare organization has been asked by the project team to solicit involvement of a physician in the next phase of a clinical systems implementation. Which of the following is the first step for the project manager to accomplish this?
Answer: C
Explanation:
The first step should be to ask the Chief Medical Officer (CMO) for candidate recommendations because physician participation in clinical systems implementation is most effective when it is leadership-supported, appropriately vetted, and aligned with medical staff governance . The CMO (or equivalent physician executive leadership) understands physician leadership structures, department dynamics, credibility considerations, and who has the influence, availability, and interest to serve as a physician champion, subject matter expert, or governance representative. This approach also reinforces shared accountability: clinical transformation is not "an IT project," and engaging physician leadership early helps secure buy-in, clarify expectations for time commitment, and ensure representation reflects organizational priorities and patient safety needs.
The other options are less effective as a first action. A mass email (A) may produce volunteers, but not necessarily the right physician leader or specialty representation, and it can bypass medical staff leadership norms. Requesting volunteers at a medical staff meeting (C) is public and time-bound, and still may not yield a suitable, supported candidate. Developing incentives (B) may be helpful later for protected time or compensation, but selecting the right physician partner and sponsorship structure comes first. Therefore, engaging the CMO for recommendations is the best initial step.
NEW QUESTION # 45
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