When Evaluating the Success of Providers in Meeting Standards, a Health

question 160

Multiple Choice

When evaluating the success of providers in meeting standards, a health plan must make adjustments for case mix or severity. One true statement about case mix/severity adjustments is that they:

• A) Typically are more important in measuring the performance of PCPs than they are in measuring the performance of specialists
• B) Help compensate for any unusual factors that may exist in a provider's patient population or in a particular patient
• C) Tend to increase the number of providers who are considered to be outliers
• D) Allow for a more equitable comparison of data between providers of outpatient care but not providers of inpatient care

---

Definitions:

Negative Net Present Value

A financial metric indicating that the present value of cash inflows is less than the present value of cash outflows, suggesting the investment is not financially viable.

Initial Cost

The upfront expense incurred to purchase an asset or to initiate a project.

Net Present Value

A calculation that compares the value of a dollar today to the value of that same dollar in the future, taking inflation and returns into account.

Required Rate

The minimum return an investor expects to achieve when investing in a particular asset or project.