Free CMGT-BC Practice Test Questions

A case manager evaluates a patient's clinical progress and arranges for their transfer from an acute care hospital to a sub-acute rehabilitation center. This decision is intended to align the intensity of services with the patient's current medical status while optimizing healthcare expenditures. This intervention best illustrates which core attribute of case management?

Which external economic or regulatory factor primarily accelerated the adoption of provider-based case management models that merge utilization review with discharge planning within acute care settings?

A managed care organization utilizes data analytics to review historical claims, demographic details, and clinical patterns. The goal is to pinpoint patients likely to require intensive resources and incur significant expenses in the coming year. What is this analytical process called?

A community hospital with limited staffing resources aims to restructure its case management department to ensure adequate coverage for both utilization review and discharge planning. Which organizational model is most compatible with these operational constraints?

A patient recovering from an acute stroke declines a recommended transfer to a skilled nursing facility, insisting on a discharge to home despite safety concerns. Which case management action best reflects the ethical principle of advocacy?

To transition from parallel practice to an authentic collaborative partnership that effectively influences resource consumption and medical decision-making, which action should the hospital case manager prioritize?

A case manager is coordinating discharge for an elderly patient with multiple comorbidities who requires expensive durable medical equipment (DME). To align with current commercial payer strategies for cost containment and administrative efficiency, which mechanism is the case manager most likely required to use for benefit confirmation?

A nurse case manager is applying the Clinical Resource Management (CRM) disease management model to a patient population with recurrent heart failure admissions. Which strategy is a primary focus of this care delivery system?

A patient presenting with significant functional limitations, specifically the inability to ambulate or communicate verbally, is being assessed for discharge. Although the family is cooperative, they confirm they are unable to supply 24-hour supervision or finance private assistance. Given these constraints, which discharge plan is clinically indicated?

In the design of case management systems, which set of variables primarily dictates the level of intensity and complexity required for effective care coordination?

A case manager identifies that a significant medical error has occurred during a patient's care trajectory. To adhere to ethical, moral, and legal standards, which course of action should the case manager prioritize?

A healthcare provider evaluates a patient to determine eligibility for hospice care. Which clinical finding represents a core physiological indicator of end-stage disease?

A 78-year-old patient expresses a desire to continue living at home ('aging in place') but lacks reliable transportation to medical appointments and struggles with meal preparation. Which federal framework is primarily responsible for coordinating the state and local infrastructure that provides these specific community-based supportive services?

A case manager is counseling the family of a patient with a chronic neurological condition regarding long-term home management. The family expresses concern about their ability to maintain constant supervision without breaks. Which resource should the case manager recommend to provide temporary relief and prevent caregiver burnout?

A post-implementation audit of a Case Management Information System (CMIS) reveals that the current reminder rule—sending written instructions for inhaler use—has resulted in a 70% non-compliance rate regarding proper technique after 30 days. Which action aligns with the principles of iterative rule evaluation and system logic?