Chapter 4: Medication Therapy Management Quality and Performance Improvement

Chapter 4. Medication Therapy Management Quality and Performance Improvement

The Institute of Medicine strategies for healthcare improvement include:

a. paying for injuries resulting from unsafe care.

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

c. prescribing the role of each profession.

d. requiring the use of telehealth technology.

e. None of the above.

CMS MTM-related star ratings:

a. are based on pharmacy ADR detection and resolution.

b. are primarily focused on Part D MTM.

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

d. may change from year to year.

e. are used for healthcare organization accreditation purposes.

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

a. civil monetary fines for underperformance.

b. members being automatically disenrolled from the plan.

c. loss of quality bonus payment.

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

e. All of the above.

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

a. a rate-based measure system.

b. proven to improved patient outcomes.

c. including diagnostic accuracy measures.

d. including physician acceptance rates of suggested therapeutic changes.

e. primarily focused on formulary design.

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

a. overall star ratings will be 4.

b. overall star ratings will be 4.5.

c. overall star ratings will be 5.0.

d. a quality bonus of 5%.

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

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

a. Beneficiaries

b. Standards of care