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  #171  
Old 11-09-2019, 08:38 AM
WamBamPassExam WamBamPassExam is offline
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Quote:
Originally Posted by BigBlackBen View Post
I just wrote one page of random stuff for question 6
same here, just stated the obvious.

Spoiler:
"both were created to reduce costs, but one is a new form of provider created by MSSP to increase quality and reduce costs in Medicare, DM programs are used by payers to manage the care of members who have chronic conditions."


think I gave enough for full credit, unless there is some part of the syllabus that compares them in detail that I missed.

Quote:
Originally Posted by BigBlackBen View Post
I forgot how much of a struggle question 4 was until I flipped through the exam again
i docked myself a few for that one. at least the biggest chunk of points was comparing traditional risk management and ERM. I think i had that down. (but so did everyone else probably.)
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  #172  
Old 11-09-2019, 09:36 AM
BigBlackBen BigBlackBen is offline
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Quote:
Originally Posted by WamBamPassExam View Post
same here, just stated the obvious.

Spoiler:
"both were created to reduce costs, but one is a new form of provider created by MSSP to increase quality and reduce costs in Medicare, DM programs are used by payers to manage the care of members who have chronic conditions."


think I gave enough for full credit, unless there is some part of the syllabus that compares them in detail that I missed.



i docked myself a few for that one. at least the biggest chunk of points was comparing traditional risk management and ERM. I think i had that down. (but so did everyone else probably.)
Your list actually hit most of the main points so you likely got majority of the points.

question 6 should be answered using two texts

there are a list of similarities from Duncan chapter 3

1. rely on identification of at risk members
2. evaluate patient condition/provide coaching
3. rely on evidenced based care/std treatment
4. rely on member participation in own care
5. hard to asses and justify financially

and the other Duncan book chapter 22 has a list of differences

1. DM has been around longer
2. ACO assigned patient to PCP to provide quality care
3. DM lack strong tie to patient's physician
4. ACO directed by provider practice rather than insurer
5. DM emphasize cost savings and quality improvement while ACO emphasize quality improvement

I think if you put down 6 of the 10 you should get the full 3 points no problem

Part b. of question 4(compare traditional risk management and ERM) was the only part directly from a MATE notecard, I think most people got those 3 points. Part a. and c. were a bit more obscure

edit: where do you think you lost points?

Last edited by BigBlackBen; 11-09-2019 at 09:49 AM..
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  #173  
Old 11-09-2019, 11:26 AM
WamBamPassExam WamBamPassExam is offline
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Quote:
Originally Posted by BigBlackBen View Post
I think if you put down 6 of the 10 you should get the full 3 points no problem
Looks like there were actual lists, so I'm probably out of luck. Hopefully I get some credit for giving a reasonable answer.

Quote:
Originally Posted by BigBlackBen View Post
where do you think you lost points?
Not sure I can say where I lost points, I my answers were like this:

4a:

Spoiler:
1. Pro: Don't use resources maintaining the network, Con: fees and inability to control which providers are in network.
2. Pro: TPA handles admin functions Con: lose control over those functions
3. Pro: higher enrollment, Con: higher induced demand of ppl who want platinum coverage


4c:

Spoiler:
I created a table of the following:
-Risk management culture
-Risk controls
-Emerging risk management
-Risk models
-Strategic risk management
and tried to think of controls that could be implemented to generate positive ratings, such as "have someone from UW, pricing, and claims on the RM committee."
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  #174  
Old Yesterday, 08:27 PM
ncrifa1 ncrifa1 is offline
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I decided to put myself through the torture of the exam again. I just finished the DMAC and was trying to see how much of a shot I had at the March FAC.

Pretty much in agreement with a lot of the commentary on AO. Thought I missed anywhere between 3.5 and 10.5 points. I thought #1, 3, and 5 were absolute gifts (half the exam points).

I thought the 4c wanted to go into the "Risk Controls" specific to the "insurance risk" which was from the Ratings Direct material's appendix(one of the risks from the credit, interest rate, market, insurance, and operational list). I used a more outside the box approach to address the risk controls around pricing, UW, and claim management to improve the "Risk Controls" score within the overall ERM score.

At least we beat bama.
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