The primary goal of a heart failure clinic is to reduce hospital readmissions by providing comprehensive outpatient care. A decreased readmission rate directly reflects the clinic's effectiveness in managing patients' conditions and preventing complications that would necessitate rehospitalization.
Reference:Centers for Medicare & Medicaid Services (CMS)

Proactively controlling costs involves anticipating and preventing unnecessary expenses before they occur, requiring a forward-looking data review approach.
Option A (Retrospective): Retrospective reviews analyze past data, useful for identifying trends but not proactive cost control.
Option B (Prospective): This is the correct answer. The NAHQ CPHQ study guide states, "Prospective data review analyzes planned interventions or patient care to prevent unnecessary costs, such as avoiding inappropriate procedures" (Domain 2). Examples include pre-authorization reviews.
Option C (Administrative claims): Claims data is retrospective, analyzing costs after services, not proactively controlling them.
Option D (Clinical records): Clinical records are typically retrospective, not forward-looking for cost prevention.
CPHQ Objective Reference: Domain 2: Health Data Analytics, Objective 2.5, "Use data for cost control," emphasizes prospective reviews for proactive management. The NAHQ study guide notes, "Prospective reviews prevent costly errors by evaluating plans in advance" (Domain 2).
Rationale: Prospective reviews enable cost control before services are rendered, aligning with CPHQ's data analytics principles.
Reference: NAHQ CPHQ Study Guide, Domain 2: Health Data Analytics, Objective 2.5.

The best process measure to evaluate effective clinical care in a new urgent care clinic is the percentage of antibiotic prescriptions that meet evidence-based guidelines. This measure directly reflects the quality of clinical decision-making and adherence to best practices, which are crucial for providing effective and safe patient care. It helps ensure that antibiotics are prescribed appropriately, reducing the risk of resistance and other complications.
Percent of patients rating care as "satisfactory" or "highly satisfactory" (A): This is a patient satisfaction measure, which is important but not a direct measure of clinical care effectiveness.
Raw number of influenza vaccines given (B): This is a volume measure, which does not directly reflect the quality of clinical care.
Average wait time between check-in and seeing a provider (D): This is a measure of efficiency, not necessarily of clinical care effectiveness.
References
NAHQ Body of Knowledge: Process and Outcome Measures in Quality Management NAHQ CPHQ Exam Preparation Materials: Evaluating Clinical Care Quality
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