AHIP Network Management AHM-530 Question # 92 Topic 4 Discussion

AHIP Network Management AHM-530 Question # 92 Topic 4 Discussion

AHM-530 Exam Topic 4 Question 92 Discussion:
Question #: 92
Topic #: 4

The Azure Health Plan strives to ensure for its plan members the best possible level of care from its providers. In order to maintain such high standards, Azure uses a variety of quantitative and qualitative (behavioral) measures to determine the effectiveness of its providers. Azure then compares the clinical and operational practices of its providers with those of other providers outside the network, with the goal of identifying and implementing the practices that lead to the best outcomes.

Qualitative measures that Azure could use to assess provider performance include an evaluation of how


A.

Quickly the provider responds to plan members’ inquiries


B.

Effectively the provider communicates with plan members


C.

Often the provider refers plan members for ancillary services


D.

Many plan members visit the provider per month


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