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AHIP AHM-530 Exam - Topic 4 Question 127 Discussion

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

AHIP AHM-530 Exam - Topic 4 Question 127 Discussion

Actual exam question for AHIP's AHM-530 exam
Question #: 127
Topic #: 4
[All AHM-530 Questions]

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

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Suggested Answer: A

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Oneida
4 days ago
Totally agree, that's the fairest way to compare them.
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Rikki
9 days ago
Sounds like a case mix/severity adjustment to me!
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Josue
14 days ago
I’m leaning towards A as well, but I wonder if there are any situations where structural measures could apply here. It’s tricky!
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Tess
19 days ago
I feel like I've seen questions like this before, and case mix adjustment seems to fit best. But I’m a bit confused about the other options.
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Kent
24 days ago
I'm not entirely sure, but I remember something about external performance standards being used in similar scenarios. Could it be B?
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Shelia
29 days ago
I think the answer might be A) case mix/severity adjustment since it sounds like they are trying to level the playing field between the two doctors.
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