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- Certified Case Manager Quality and Outcomes Measurement Questions and Answers Flashcards

6 cards from real CCM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. What is the Donabedian model in quality measurement?

    Answer: A framework evaluating quality through structure, process, and outcomes

    The Donabedian model evaluates quality through three interconnected dimensions: structure, process, and outcomes.

  2. Which quality improvement methodology uses Plan-Do-Study-Act (PDSA)?

    Answer: The Model for Improvement

    The Model for Improvement uses PDSA rapid-cycle testing methodology.

  3. What is HEDIS?

    Answer: A comprehensive set of standardized performance measures for evaluating health plans

    HEDIS is a standardized performance measurement set maintained by NCQA for evaluating health plan quality.

  4. What is a 'balanced scorecard' approach to case management performance?

    Answer: A framework evaluating performance across financial, client, process, and learning/growth perspectives

    A balanced scorecard measures across financial, client, process, and learning/growth dimensions.

  5. What is the difference between a quality indicator and a quality standard?

    Answer: An indicator is a measurable variable signaling quality; a standard is the threshold it should meet

    Indicators measure aspects of performance; standards define acceptable thresholds.

  6. How does 'value-based care' impact outcomes measurement?

    Answer: Shifts focus from service volume to outcomes achieved relative to cost

    Value-based care measures outcomes achieved relative to cost, aligning with case management's dual goals.