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Chapter 4. Medication Therapy Management Quality and Performance Improvement

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The Institute of Medicine strategies for healthcare improvement include:

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a. paying for injuries resulting from unsafe care.

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b. applying the Medicare star ratings to community pharmacy practice.

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c. prescribing the role of each profession.

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d. requiring the use of telehealth technology.

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e. None of the above.

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CMS MTM-related star ratings:

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a. are based on pharmacy ADR detection and resolution.

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b. are primarily focused on Part D MTM.

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c. are used to inform the public about diagnostic error rates.

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d. may change from year to year.

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e. are used for healthcare organization accreditation purposes.

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Star rating underperformance by an MA-PD can result in:

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a. civil monetary fines for underperformance.

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b. members being automatically disenrolled from the plan.

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c. loss of quality bonus payment.

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d. the MA-PD plan being required to switch to a PDP.

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e. All of the above.

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The CMS MA-PD PDP star performance measures system is best characterized as:

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a. a rate-based measure system.

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b. proven to improved patient outcomes.

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c. including diagnostic accuracy measures.

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d. including physician acceptance rates of suggested therapeutic changes.

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e. primarily focused on formulary design.

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Improving the MA-PD medication star measures for an individual plan from 4 to 5 guarantees:

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a. overall star ratings will be 4.

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b. overall star ratings will be 4.5.

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c. overall star ratings will be 5.0.

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d. a quality bonus of 5%.

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e. nothing, as the rating depends on other performance measures.

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Which of the following are included in the CMS quality improvement framework?

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a. Beneficiaries

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b. Standards of care

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