Care Coordination & Resource Management Flashcards
7 cards from real CCM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Care Coordination & Resource Management flashcards as text
A care manager is developing a care plan for a recently discharged stroke patient. Which element is ESSENTIAL to prevent 30-day readmission?
Answer: Arranging a follow-up appointment within 7 days of discharge
Early post-discharge follow-up within 7 days is a key evidence-based strategy to detect complications and prevent readmission.
The concept of 'warm handoff' in care transitions refers to:
Answer: A direct, real-time introduction between the outgoing and receiving care team members
A warm handoff involves a direct personal introduction or communication between providers to ensure continuity and reduce information loss.
Which model specifically uses 'health coaches' and 'community health workers' as part of a care coordination team?
Answer: Chronic Care Model
The Chronic Care Model incorporates community resources and self-management support, often delivered by health coaches and community health workers.
A care manager is prioritizing a caseload of 25 clients. Which client should receive IMMEDIATE attention?
Answer: A client discharged yesterday with no post-acute services arranged
A newly discharged client with no post-acute services is at high risk of adverse outcomes and requires urgent care coordination.
In the context of resource management, 'utilization review' is BEST described as:
Answer: Assessing whether healthcare services are medically necessary and appropriate
Utilization review evaluates whether specific services are medically necessary, appropriate in setting, and cost-effective.
A care manager identifies a client who qualifies for the Supplemental Nutrition Assistance Program (SNAP) but has not enrolled. The BEST action is to:
Answer: Provide information and assist with the application process as appropriate
Proactive assistance with benefit enrollment is a core care management function that addresses social determinants of health.
Which organization publishes the Standards of Practice for Case Management used as a professional benchmark in the US?
Answer: Case Management Society of America (CMSA)
CMSA publishes the Standards of Practice for Case Management, which define competencies and ethical practice for the profession.