Misadventures in Utilization
Alphabet soup
Medicare odds and ends
RAFfle
100

Dr. Millie gets dehydrated from running on the beach all day after 2 months of quarantine, followed by a few too many drinks.  He's at home and doesn't want to visit the WIC, so he calls dispatch health.  The average cost of his visit is this. 

What is $350? 

100

APT

What is admits per thousand?

100

Medicare is divided into 4 parts.  Medicare Advantage is this part

What is Medicare part C?

100

RAF stands for this

What is "Risk Adjustment Factor?"

200

Dr. Chalaka decides to try out vaping after a crazy weekend with his old college buddies.  Unfortunately he develops vaping induced lung injury and gets admitted to the hospital.  The would be the average cost of his stay

What is $13,000?

200

PMPM

What is per member per month?

200
Percentage of cost patients could be responsible for in traditional medicare (FFS, no supplement). 

What is 20%?

200

HCC stands for this

What is Hierarchical Condition Category

300
Dr. Heshmati, after a few cocktails on the plane, accidentally takes too many Ambien when flying back from DC after meeting with the President.  He is admitted to observation for confusion.  The average cost of his stay is this. 

What is $2600?

300
DRG

What is Diagnosis related group?

300

Hospital care is covered under this part of medicare

What is part B?

300

The version of HCC codes/RAF that we are using in 2020

What is version 24? 

400

Dr. Chen injures himself in an unfortunate zoom accident when he forgets his state of undress and moves too quickly.  He visits the ER to get sutures, the average cost of his visit would be this

What is $700?

400

POP

what is percent of premium?

400

Dr. Hu's favorite number, and the one associated with the maximum rebate

What is 5?

400
Chronic and Acute diseases are 2 things that contributed to RAF; however, even someone with no conditions has a RAF score.  These factors determine the demographic portion of RAF. 

What is age, living situation and disability status?

500

Dr. Rosenberg gets injured during a secret anesthesiology MMA contest, sustaining several fractures which required SNF placement.  The average cost of his SNF stay would be this

What is $9000?

500

DOFR

What is division of financial responsibility?

500

Number of times Millie has to look up the meaning of "DOFR" each day, and the meaning of life

What is 42? 

500
Name at least one new HCC contributing to RAF for 2020

What are Dementia, Dementia with complications, and pressure ulcer of skin with partial thickness skin loss

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