CPHRM, Risk Management & Insurance Regulation

Which of these factors contributed to the evolution of healthcare risk management in the 1970s?

What is the primary aim of risk management?

According to the content, what is the definition of 'harm' in the context of healthcare risk management?

What is the focus of traditional risk management in healthcare?

Why is there a shift occurring from traditional risk management to enterprise risk management?

Which of the following accurately describes Enterprise Risk Management (ERM)?

According to ASHRM's definition, what does ERM in healthcare promote?

What is the primary difference between Traditional Risk Management (TRM) and Enterprise Risk Management (ERM) in terms of their focus?

Which of the following steps is part of the process for ERM as a Decision-Making Process?

What is the first step in the risk management process?

Incident reports serve as a cornerstone to which one of the following concepts?

What is the goal of providing Risk Management Training?

When classifying exposures, what are the three mentioned exposure types?

Which one of the following methods is for the treatment of an exposure using risk management techniques?

What is the primary goal of risk financing?

What is the distinction between risk control and risk financing?

What does 'current expensing of losses' refer to in risk retention?

What is meant by 'unfunded loss reserve' in the context of risk financing?

What is the purpose of risk retention groups?

Which type of insurance provides payment if a party suffers a type of loss listed in their agreement?

What is the meaning on Insurance?

What is a direct function that financial Guarantees Provide?

Which of the following steps is the primary focus of regulation of insurance at the state level?

What factors define drafting specification coverage?

During a soft insurance market which option is more possible?

How are a Broker and Agent different?

Which is a key attribute to find when hiring a new broker?

Which members are required for Insurance?

Which best describes the point/expertise of Underwriter?

What is the defintion or reference to for Retractive Rate?

Under typical insurance policy, what is the date where all records have been recorded and updated for the insurnace company?

What to retain less a loss exposure and what action might you have to take under this market shift ?

What does one need to be well covered?

What step involves finding what is the core basis for each type from this point ?

To create a standard or agreement which of the following needs to occur or be in order to manage this?

What would be one be required to do know all is in placed?

What is considered the primary objective of traditional risk management?

What is the ultimate goal of the risk management process?

In the context of healthcare risk management, what does the term 'hazard' primarily refer to?

What is the primary focus of Enterprise Risk Management (ERM) regarding risk?

Which is one of the key goals of Enterprise Risk Management (ERM) in healthcare?

How does Enterprise Risk Management engage stakeholders compared to Traditional Risk Management?

What is the purpose of 'monitoring' in the ERM decision-making process?

During risk identification, what is the purpose of determining the 'type of value exposed to loss'?

Which of the following methods is considered a 'formal' approach to risk identification?

What is the primary objective of reporting incidents in healthcare risk management?

In risk ranking, after you identify the level and the likelihood of a certain step. What is next when performing a risk ranking calculation?

The step of 'Treatment' in Risk Management has goals to achieve which of the following choices?

What is the overall goal of risk financing?

According to one risk control technique, what would one do if a risk has been determined to be outside of all acceptable safety measures?

What must someone provide to receive payment on their insurance policy?

Under insurance non-insurance, what is an important thing to find under these services?

With insurance to be considered, one must ensure:

When examining professional liability, which one of these has the potential to add more data?

What role helps with data to be calculated under actuarial use?

The part of your contract that defines the most standard data for insurance is?

Once an issue has been listed, what best helps guide steps and potential solutions for these incidents?

When changing providers to new medical care. Which option allows one to stay in-line and with better support?

If a report mentions the topic 'Nose Coverage' what might it mention?

When are the costs under retro come?

According to Insurance groups, what is the most important for plans?

Most steps require which thing from the brokers?

Depending on Underwriter to account to follow the data provided to be correct

What are four steps that can help and be the correct steps?

All steps and changes need well- what?

When a plan does not follow what has been set, what then should occur?

If a plan has high value, what makes them important to run?

If an agency wanted to retain less loss exposure and potentially look to transfer more to the insurance company, should they look to be in more of a soft market or a hard market?

To follow one of the steps for help and action, what needs to be done before the correct actions arrive?

When working with a contract that requires insurance, what needs to be considered first?

If all was in place for steps, what then is required?

Which of the following actions is most aligned with the use of 'risk control' after considering Risk Identification and before Risk Financing?

How do risk reduction techniques aim to reduce or mitigate a loss?

Which of the following exposures does NOT belong under third party insurance coverage?

Under direct insurance, what is the purpose of having 'excess insurance'?

If a company wanted a plan in which they pay per individual losses, self insurance, how often do they expect those pay?

An organization fails to monitor slippery floor. The family pushing patient sues.

The part of your contract that defines the steps involved as best and all.

During self insurance (credit risk), how should funds function under what?

According to the plan, what might you expect to see as a benefit from coverage Insurance?

Which of the following is a good area for support?

In the insurance world, what would someone need to understand what they do?

According to a legal case, what 3 parts need to have those to be legal and to hold the standards (select all that apply)?

In traditional risk management, what is a common approach to handling risk?

What is the primary difference in focus between traditional and Enterprise Risk Management (ERM)?

What distinguishes the 'Strategic' category of Enterprise Risk Management (ERM) risk categories?

In the context of ERM goals, what does 'reducing uncertainty and process variability' primarily aim to achieve?

Which viewpoint accurately characterizes Risk Avoidance as a risk control technique?

What is the main function of 'Loss Prevention' as a risk control technique?

How do contracts containing hold-harmless agreements function under risk control techniques?

What is the goal of Risk Financing techniques used in risk management?

Which option accurately defines 'current expensing of losses' within Risk Retention?

In the domain of insurance, what is a 'captive insurer' most akin to?

What fundamentally defines 'Insurance' in the context of risk transfer?

Under insurance policies incorporating a 'deductible', who bears the responsibility for covering expenses up to the deductible amount?

Within insurance policies, what signifies the 'declarations page'?

Which insurance sector is 'HMO/Capitation stop loss' most pertinent to?

What is a claims-made insurance policy most distinguished for?

What is meant when an insurance provider cites 'Nose Coverage'?

With what is "cost certainty" best associated within a risk financing context?

Under an insurance arrangement, what primarily motivates using actuarial reviews?

Which attribute should a business value when looking for a new broker?

To ensure well covered, well support and better support, which option allows one to stay in-line?

Under a "claims-made" insurance policy, what action is critical for coverage if an incident occurs near the end of the policy term?

Which factor would likely be the MOST influential for a hospital when deciding between a traditional insurance plan and a self-insured retention (SIR) plan?

What is the primary role of an actuary in the context of healthcare risk management and insurance?

How does an 'unfunded loss reserve' function within risk retention?

What is the MOST complete and accurate definition of an insurance policy's 'declarations page'?

What type of policy would be used at 2 different points to insure 2 groups of physicians, where one group had past coverage and one group is about to set up new coverage:

How do economic conditions affect risk transfer/insurance plans?

In a risk-financing context, what does “cost certainty” MOST directly imply for an organization?

What action best helps create steps and solutions for listed issues?

In a "hard insurance market", what is a likely outcome for insurance buyers?

Given a healthcare organization with a mature ERM program, which metric would MOST comprehensively reflect the program's efficacy in fortifying resilience against systemic shocks, such as pandemics?

An integrated delivery network (IDN) is contemplating shifting from a traditional insurance model toward a risk retention strategy involving a captive insurer. What critical prerequisite must be satisfied to ensure the economic viability and regulatory compliance of this captive?

When evaluating a claims-made insurance policy, what are the MOST critical considerations regarding 'nose coverage' (prior acts coverage) and 'tail coverage' (extended reporting period) a risk manager should analyze?

A large academic medical center is considering implementing a 'blended risk transfer/retention' strategy, utilizing both a high-deductible insurance policy and a captive insurer. What are the MOST important factors the CFO needs to evaluate to confirm the economic viability of that plan?

In a healthcare system characterized by high operational complexity and interdependence, what is MOST critical to establishing a robust and proactively managed risk management framework?

If an insurance company references IBNR (Incurred But Not Reported) in their actuarial reports, what does this MOST accurately suggest regarding their estimation of total liabilities?

Under a “retrospective rating” plan, what does it MOST directly indicate of the final premium determination at the end of the policy period?

Suppose a hospital implements a new patient safety protocol aimed at reducing surgical site infections (SSIs). Which quantitative metric would BEST reflect the efficacy of this risk control technique?

What is the MOST critical distinction between a claims-made and an occurrence insurance policy from a long-term risk management perspective?

An organization is conducting due diligence on potential insurance brokers. Beyond standard qualifications and experience, what MOST accurately demonstrates their capacity to develop innovative risk financing solutions tailored to their organizational profile?

Risk management in healthcare primarily addresses potential financial gains.

According to the presentation, strategic planning is not within the scope of Dr. Sahar Khalil Alhajrassi's expertise.

Enterprise Risk Management (ERM) seeks to manage risks across the entire organization.

Traditional Risk Management (TRM) and Enterprise Risk Management (ERM) are essentially the same thing.

The ultimate purpose of Risk Management is to eliminate all potential harm.

Incident reporting should focus solely on serious occurrences, ignoring minor events.

In the context of risk management, 'transfer' refers to shifting the financial burden of risk to another party.

A 'potentially compensable event' (PCE) is an occurrence that is guaranteed to result in a lawsuit.

An insurance policy's 'declarations page' typically includes the insured's claims history.

A 'hard' insurance market is defined by easily accessible and affordable coverage options.

Traditional risk management encourages open communication with patients and their families regarding findings after an adverse event.

The overarching goal of modern risk management is to provide the least amount of protection, thus maximizing profits at the expense of patient safety.

Strategic risks, unlike financial risks, are considered outside the scope of Enterprise Risk Management.

An insurance policy's exclusions define what the policy will cover under specific circumstances.

A key goal of enterprise risk management is to increase uncertainty to promote innovation.

Risk management is primarily handled by a single department within an organization.

In risk management, 'insurance risk' refers to the potential harm a company could suffer due to fluctuating insurance rates.

Risk Control involves addressing financial losses after they occur.

A company can transfer the financial burden but NOT necessarily the ultimate legal responsibility for losses.

ISO 31000 is explicitly mentioned as a required compliance standard for healthcare risk management in the provided materials.

Risk management is a static process that does not require continuous monitoring or updates.

Operational risks are primarily related to external factors like market competition.

A self-insurance trust provides more flexible spending options for funds compared to other arrangements.

In a 'claims-made' insurance policy, coverage is determined solely by when the incident occurred, regardless of when the claim is reported.

To obtain insights into an organization's total cost of risk, it is unnecessary to consider uninsured losses.

The "stop-loss" method is designed to determine what point of cost containment provides maximal value, at no cost, and with high specificity.

A key element of a 'market proposal' for insurance purchasing is that broker selection depends primarily on cost and services, rather than broker experience.

The data listed, does not, generally need to be in both actuaries, claims, finance, and the legal department; instead, the claim department is supposed to receive that information.

In the context of insurance, 'Incurred But Not Reported' (IBNR) refers to losses related to property damage.

A key advantage of a 'conceptual proposal' is the speed. Using the conceptual approach will generate, overall, faster results and more streamlined responses.

There is no need for retroactive date when coverage is claims made.

It is crucial for insurance departments to get licensed to make claims

It is more important to evaluate a broker than the actual insurance policy

Having all C-suite at an organization with no prior knowledge in risk management decisions allows for a more diverse risk.

The overall number rating is more important if an organization is in-prevention or non preventable risk.

It's common practice to utilize an older company, from sometime in the 1970s, for financial protection.

It is more safe to be audited in certain risk rather than not at all.

It is not important to use different types of financial and insurance regulation.

Once an insurance policy is in place, the premiums cannot be changed, even with an increase in risk.

Actuaries are experts specialized in evaluating risk, but are not generally consulted on insurance pricing.

Enterprise Risk Management's primary objective is to enhance the volatility of an organization's strategic planning, disregarding the interconnectedness of risks and their potential synergistic effects.

In traditional risk management, the assessment of risks heavily weighs speculative gains over potential losses, focusing predominantly on opportunities for financial upside.

The 'retention ratio' in risk financing techniques invariably entails the complete transfer of financial responsibility to a third-party insurer, nullifying any direct financial burden on the insured entity.

Under a 'claims-made' insurance policy, coverage is triggered simply by the occurrence of the insured incident, irrespective of when the claim is actually reported to the insurer.

In determining the cost of risk, financial auditing expenses are classified uniquely under 'hazard' risks, precluding their allocation to operational or strategic risk assessments.

Regarding insurance purchasing, agents invariably represent only the purchaser, advocating exclusively for their interests in coverage and pricing.

In insurance contracts, there is no relationship to third-party contracts.

Operational risk invariably relates to risks from workplace safety alone.

From the point of view of minimizing losses then it's best that organizations should take a reactive approach with Traditional Risk management.

There are four important aspects to any definition of Risk Management: Risk Indifference; Risk Appetite; Risk Evaluation; and Risk Monitoring.

Match the following risk management terms with their definitions:

Match the following aspects of traditional risk management to modern Enterprise Risk Management (ERM):

Match Risk Categories (ERM) to their descriptions:

Match the insurance terms with their appropriate definition:

Match the characteristics of hard and soft insurance markets:

Match the following 'levels' of excess coverage with their descriptions:

Match the roles involved in insurance purchasing with their responsibility:

Match the following insurance policy types to its description:

Match the risk financing techniques with their description:

Match types of Risk Retention techniques:

Match the workers compensation to the financial benefit that the affected employee has :

Match following types of financial instruments listed to their definitions:

Match the words used to describe the purpose of having an insurance policy to its description:

Match the following financial ratios to better make informed choice for best rates:

Match up the following terms used for "Due Diligence", to avoid fraud and abuse claims:

Match the following terms used in claims to their best suited description

Combine the various steps where the losses can be determined to be managed and understood

Combine key components of reporting for high volume reporting where more is needed to track..

Couple financial risks, is important in understanding what is is coming..:?

Help choose a various reason in why your organization isn't successful

Match the term with its precise definition within the context of retrospective insurance rating:

Match each risk financing technique with the appropriate characteristic:

Match the appropriate element with its correct description pertaining to insurance policy construction:

Match each term with its corresponding legal or regulatory context relevant to insurance operations:

Match the risk mitigation technique with its MOST accurate application within a healthcare setting: