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  #1  
Old 11-01-2017, 03:02 PM
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lifishing007 lifishing007 is offline
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Default Fall 2017 Post Exam

Please wait until Friday (11/3) to discuss any exam questions or thought.

I will edit this question list until it's completed. Please help me correct or fill in the blank.

Q1 ACO
1) Define ACO?
2) What ACO can do about population health.
3) Calculate standard deviation

Q2 PBM
1) Function of PBM
2) Calculating admin fee
3) Whether to accept PBM and justify your answer

Q3 LTC Reserve
1) Governing documentation on Reserve?
2) Reserve consideration?
3) Prospective and retrospective
4) PHARR's RULE!!!!
5) ???

Q4 RA?
1) Define risk assessment and risk adjustment
2) Calculate the risk transfer payment
3) Explain ACA first year risk adjustment
4) Draft a memo to CEO explain his position.

Q5 Reserve using Triangulation
1) Explain short coming of triangulation
2) Calculate reserve.
3) Credibility factor of 35%, use claim cost method (please be consistent be terminology)
4) Comment on result from 3)


Q6 MSSP calculation (I am not sure about this one)
1) Calculate Bench mark
2) Assess the ACO share saving or loss assumed 100% quality score
3) Quality score ranging from 50% to 100%, whether the ACO should enter MSSP, justify your answer.


Q7 Group Life
1) challenge of reserving for group life


Q8 DM
1) Explain the method for calculate DM saving and give example of each
2) Recommend a saving calculation method when given utilization trend of 4%
3) Calculate the saving

Q9 Retrospective Refund
1)
2) Calculate the surplus deficit for 2016
3) Recommend whether to take the approach and some contractual agreement stuff, justify your answer.

Q10 DM Case study
1) Some DM measurement listing
2) Comment on Exh 8 and Exh 9, propensity score on syllabus?

Q11 Lynd and Bundle Payment
1) Explain the contracting process.
2) Why hospital want to contract with payor
3) Calculate payment under two contract
4) Additional contractual agreement/language, justify your answer

Q12 Reserve
1) Explain active life reserve with graph.
2) Calculate the reserve using Exhibit 1
3) Explain the difference using 2 tables.
4) What can you do to improve accuracy of reserve.


Q13 Anti-selection
1) Calculate anti-selection cost
2) Calculate relative risk factor of HDHP and PPO
3) JAMES BOND stop loss.
4) Comment on deductible leverage

Q14
1) ACO attribution
2) ACO benchmark
3) ACO saving
4) Whether pursuing ACO is the correct choice.

Q15
1) Purpose of Triple Aim
2) Potential outcome measure and example
3) Difference between disease management and triple aim
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Exam: GHCORE GHADV GHSPE
Module: HF FE PRFM DMAC

Last edited by lifishing007; 11-03-2017 at 03:23 PM.. Reason: Add the list of question.
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  #2  
Old 11-03-2017, 03:23 AM
Byram Byram is offline
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Ow, my wrist

I think the scariest part of the exam was when I saw two digits of my candidate number mixed up on one of the answer sheets.

Last edited by Byram; 11-03-2017 at 03:48 AM..
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Old 11-03-2017, 03:36 AM
reddragon7588 reddragon7588 is offline
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Ditto
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GH Exams: Core Advanced Specialty
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Old 11-03-2017, 08:06 AM
Latitude30 Latitude30 is offline
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Quote:
Originally Posted by Byram View Post
Ow, my wrist

I think the scariest part of the exam was when I saw two digits of my candidate number mixed up on one of the answer sheets.
Triangulation can do that.

But exhibit 1 lags can also do that, if you think you need to go past 6 summations when you already have your ultimate in the right edge of the page

No I agree I blistered my hand too badly

Note:
A number of inhabited islands lie within the longitudinal limits of this time zone, but none of them keeps the date and time of UTC-12. Instead, they keep the time and date (or just the date) of one of the neighbouring zones, usually because they belong, politically, to an island group whose other members lie mostly in the neighbouring time zone.

Sending this at UTC-4 AKA UTC-5+DST all habited time zones of earth are at Friday 11/3

Last edited by Latitude30; 11-03-2017 at 08:43 AM..
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Old 11-03-2017, 08:16 AM
Latitude30 Latitude30 is offline
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Oh darn I just realized I and many of you may have made a small minor bloop. The exhibit 1 December 2015 incurred lag pattern you can’t use the right edge as you ultimate in age to ult because the question specifically said to assume completion at 12 lags not 13 lags. It’s right edge less the (dec-16 paid for the incurred dec-15) = Your ult assuming only 12 lags

I missed that but I think that doesn’t change your answer materially at all. I already got that dec-2015 development pattern completes faster than July -15 So cutting off the 13th paid lag for dec-2015 incurrals would make it complete even faster and same story for part d

Last edited by Latitude30; 11-03-2017 at 08:23 AM..
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Old 11-03-2017, 09:06 AM
Zachpwkc7 Zachpwkc7 is offline
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So we can talk about the exam now? Cool. Does anyone want to address a certain "Rule"? I see two scenarios, either it's just not on the syllabus because I've never seen the word before, or I'm wholly misinformed and everyone else can get their point up on me.
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Old 11-03-2017, 09:32 AM
Byram Byram is offline
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Quote:
Originally Posted by Latitude30 View Post
Oh darn I just realized I and many of you may have made a small minor bloop. The exhibit 1 December 2015 incurred lag pattern you canít use the right edge as you ultimate in age to ult because the question specifically said to assume completion at 12 lags not 13 lags. Itís right edge less the (dec-16 paid for the incurred dec-15) = Your ult assuming only 12 lags
Wasn't the Dec-16 paid amount for Dec-15 just 0? Meaning it was complete after 12 months?
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Old 11-03-2017, 10:57 AM
Latitude30 Latitude30 is offline
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Quote:
Originally Posted by Byram View Post
Wasn't the Dec-16 paid amount for Dec-15 just 0? Meaning it was complete after 12 months?
Thank you !!!!! So I got the answer I was supposed to there. But even otherwise I could assume lag1 is called lag0
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Old 11-03-2017, 11:16 AM
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bluecup129 bluecup129 is offline
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Feels like a 5. I just left too many things blank/didn't answer things as wholly as I should have.

The 4 point ACO question stumped me. I remembered reading that info the night before the exam too...just didn't stick.

I didn't study retrospective rating as much as I should have either. Oh well...sit and wait now.
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Old 11-03-2017, 11:19 AM
Latitude30 Latitude30 is offline
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Does anyone know what Pharr’s rule is?

For anything to do with ACO, you can’t go wrong getting some partial points having talking points about
Medicare FFS members, coordination of care, quality points, evidenced based care, quality/cost/ created by ACA, shared Savings with CMS, restrictions on preferential referrals, anti-trust, anti-kickbacks, noncompliance with applicable laws

One thing I could have thrown in if it asked about contracting would be the NIP database thing and site visits. But an ACO itself can be individual physician practices themselves that qualifies as ACO

There’s also that notecard about ACO regaining market share from other delivery systems and raising revenue in Medicaid shortfall

Last edited by Latitude30; 11-03-2017 at 11:29 AM..
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