AHIP Network Management AHM-530 Question # 100 Topic 5 Discussion

AHIP Network Management AHM-530 Question # 100 Topic 5 Discussion

AHM-530 Exam Topic 5 Question 100 Discussion:
Question #: 100
Topic #: 5

Dr. Sylvia Cimer and Dr. Andrew Donne are obstetrician/gynecologists who participate in the same provider network. Dr. Comer treats a large number of high-risk patients, whereas Dr. Donne’s patients are generally healthy and rarely present complications. As a result, Dr. Comer typically uses medical resources at a much higher rate than does Dr. Donne. In order to equitably compare Dr. Comer’s performance with Dr. Donne’s performance, the health plan modified its evaluation to account for differences in the providers’ patient populations and treatment protocols. The health plan modified Dr. Comer’s and Dr. Donne’s performance data by means of


A.

Acase mix/severity adjustment


B.

An external performance standard


C.

Structural measures


D.

Behavior modification


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