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Exam Code: HALM
Exam Name: Health Care Administration- Leadership and Management
Number of Questions: Approximately 200 multiple-choice questions (single-best-answer format)- including scored items and non-scored field test items.
Time Allotted: 4 hours total
Passing Score: Scaled score of 77 out of 100 (equated score; not a raw percentage).

- Signs- Symptoms and Presentations: 10%
- Abdominal & Gastrointestinal Disorders: 7%
- Cardiovascular Disorders: 10%
- Cutaneous Disorders: 3%
- Endocrine- Metabolic & Nutritional Disorders: 5%
- Environmental Disorders: 2%
- Head- Ear- Eye- Nose & Throat Disorders: 4%
- Hematologic Disorders: 3%
- Immune System Disorders: 2%
- Systemic Infectious Disorders: 7%
- Musculoskeletal Disorders (Non-traumatic): 3%
- Nervous System Disorders: 6%
- Obstetrics and Gynecology: 3%
- Psychobehavioral Disorders: 2%
- Renal and Urogenital Disorders: 3%
- Thoracic-Respiratory Disorders: 7%
- Toxicologic Disorders: 4%
- Traumatic Disorders: 9%
- Procedures & Skills: 8%
- Other Components: 2%

Total: 100%

- Accounting principles- financial controls- P&L- and financial statements
- Business plan development (e.g.- adding new services- return on investment)
- Capital budgeting and asset management (e.g.- funding sources- long-term implications of capital planning- such as depreciation)
- Contracts legal and financial implications

- Financial decisions' impact on operations- health care- human resources- and quality of care
- Fundamental productivity measures (e.g.- hours per patient day- cost per patient day- units of service per labor hour)
- Funding sources (e.g.- issuance of bonds- philanthropy- grants- and foundations)

- GME reimbursement models and associated regulatory/compliance law (e.g.- IME- DME)
- Interpretation of marketing data (e.g.- market analysis- market research- sales- advertising)
- Methods for determining community gaps/need for health care services (community need)
- Methods for determining the fair market value for services provided (clinical- academic affiliations- teaching- or research)

- Negotiation strategies and techniques
- Operating budget principles (e.g.- fixed vs. flexible- zero-based- variance analysis- contribution margin)
- Prioritization of capital resources and associated conflict resolution
- Reimbursement methodologies (e.g.- academic- managed care models- federal/state matching- value-based- fee-for-service- risk-based)

- Centers for Medicare and Medicaid payer-based models
- Revenue generation (e.g.- billing- coding- new ways to generate revenue- pricing strategies- and transparency)
- Stark- antitrust- and kickback laws related to physician services
- Mergers and acquisitions
- Vendors and payor relations
- Contract and vendor sourcing
- Business community relations
- Advertising and marketing
- Taxation law
- Collaborating with competitors

- Health disparities
- Health care access- quality- cost- resource allocation- accountability- and the community
- Health care trends and barriers across the continuum of care (e.g.- extended care- acute hospital care- ambulatory care- home care)
- Non-traditional settings and methods to Strengthen access
- Hospital-at-Home

- Patient-centered care
- Social determinants of health
- Community Social Services Relations
- Telehealth impact and other emerging technologies
- Value-based care models
- ACOs

- Bundled payment models
- Clinically integrated networks
- Co-management agreements
- MIPPS/MACRA
- The transition from volume to value-based care implementation

- Health system governance structure (e.g.- bylaws- articles of incorporation) and operations (e.g.- board member selection- education- orientation- monitoring- and exam)
- Board member conflicts of interest- dualities of interest
- Administrative staff conflicts of interest- dualities of interest
- Health system governing board models- roles- and responsibilities- e.g.:
- Financial oversight (nonprofit vs. for-profit settings)
- Patient safety and assurance of the quality of care
- Preservation of assets- reputation- and risk management
- Statutory and regulatory compliance
- Strategic planning

- Health system physician leader's role (e.g.- CMO/VPMA) with board/institutional governance and medical staff
- Medical staff structure and its relationship to governing bodies (e.g.- board oversight of credentialing- privileging- employed vs. voluntary models- and disciplinary process)
- Medical staff call obligations and compensation
- Public policy- legislative- and advocacy processes
- Philanthropic and investment processes

- Organizational-level committee structure and participation
- Management of single-entity versus federation of entities
- Matrix management (e.g.- medical group- health plan)
- Coalition building
- Managing competition (internal and external)
- Interface to Medical Transport Systems
- Foundational Model and Health System Direction

- Auditing
- Clinician roles and qualifying criteria (e.g.- administrative versus clinical)
- CMS Conditions of Participation
- Compliance and regulatory (e.g.- antitrust- conflict of interest- EMTALA- Stark- billing- and coding)
- Continual readiness for accrediting/regulatory organization inspection and compliance (e.g.- TJC- ACGME- OSHA- FDA- NRC- CDC- state- federal/tribal accreditation/certification/licensure)
- GME policies and accreditation requirements

- Information security management (e.g.- PHI- HIPAA- FOIA- the release of information)
- Management of information security breaches
- Medicare and Medicaid regulations
- Other third-party payment regulations (e.g.- PPO- HMO)
- Patients' rights laws and regulations (e.g.- informed consent- advance directives- involuntary commitments)
- Regulatory reporting requirements
- Research office leadership compliance and regulation (HIC- IRB- grants management)
- Advocacy and engagement
- Lobbying entities
- Federal agencies (e.g.- MedPac)
- Organized Health care (e.g.- NQF- AHA- AMA- etc.)

- Applications
- Clinical documentation auditing and improvement strategies (role of physician advisors)
- Compliance (e.g.- HIPAA security requirements- HITECH Act meaningful use requirements)
- Data and equipment interoperability
- Data management
- Security breaches- malware- ransomware- etc.
- Ongoing innovation- maintenance
- Upgrading and conversions
- Decision support and alert fatigue

- Health care analytics
- Big data
- Augmented intelligence
- HIPAA
- HITECH Act meaningful use
- Information systems continuity and redundancy
- Physician and end-user engagement in IT strategies
- Technology lifecycles
- Technology policies and regulations
- Social media trends
- Workforce engagement and compliance with institutional systems

- Compensation and benefits practices
- Conflicts and dualities of interest (e.g.- industry relationships)
- Conflict resolution and grievance procedures
- Diversity- inclusion- and equity strategies
- Employee safety- security- and health issues (e.g.- OSHA- workplace violence)
- Employee satisfaction exam- engagement- motivation- and career development tools
- Labor relations and laws (e.g.- FMLA- FLSA- EEOC- ERISA- worker compensation)
- Performance management systems (e.g.- performance-based evaluation- rewards systems- disciplinary policies- and procedures)

- Physician satisfaction test and engagement tools and techniques
- Recruitment and retention approaches and techniques
- Staffing models- productivity management- and the impact of changes on the quality of care
- Interprofessional care delivery teams
- Succession planning models
- Workforce cultural competency strategies
- Workforce wellness
- Burnout mitigation
- Impaired individuals
- Utilization and impact of external staffing agencies

- Benchmarking standards to define- monitor- and assure evidence-based- efficient- timely- appropriate- cost-effective- equitable- patient-centered care
- High-reliability care organizational (HRO) principles- tools- and monitoring processes (e.g.- error reduction- serious safety event and near-miss reporting- just culture- root cause analysis- regulatory safety event reporting requirements- corrective action plans- and error disclosure)
- Performance standard-setting- documentation- measurement- and monitoring (e.g.- evidence-based clinical pathways- value-based care- population health- pay-for-performance- patient satisfaction)

- Principles of patient safety- methods- and legal aspects of medical staff credentialing and peer review- including OPPE and FPPE
- Process and quality improvement principles- measurement tools- and techniques (e.g.- plan-do-study-act- lean daily management- Six Sigma)
- Quality program leadership- strategic planning- operations- and financing
- Risk management principles and programs (e.g.- insurance- education- workplace safety- injury management- patient complaints- patient and staff safety- and security)
- Utilization review and leadership of case management teams
- Education in identifiable gaps in system-based practice
- Longitudinal understanding of the system-wide organizational structure
- Community initiatives (e.g.- violence prevention)
- External agency engagement (e.g.- NAHQ- AHRQ- NAM- etc.)

- Clinical operational leadership for interprofessional teams across the continuum (e.g.- planning- direction- execution- evaluation) for:
- Ancillary services (e.g.- lab- radiology- pharmacy)
- Providers (e.g.- nonprofit- for-profit- federal- public health)
- Support services (e.g.- the environment of care- plant operations- materials management- supply chain management- hospitality services)
- Collaborative techniques for engaging and working with physicians
- Contingency planning (e.g.- emergency preparedness- disaster management- National Incident Management System)
- Organizational systems (e.g.- span of control- chain of command- interrelationships of organizational units)

- Principles of media relations- advertising- social media- and community relations
- Resource allocation methods and related conflict management
- Team Leadership
- Change management
- Conflict resolution
- Diversity- equity- and inclusion
- Emotional intelligence
- Group dynamics
- Interpersonal communication
- Organizational culture development and resources
- Public relations and media
- Risk communication
- Situational leadership skills
- Team building
- Assembly

- Conflict of interest issues and solutions as defined by organizational bylaws- policies- and procedures (futile care)
- Consequences of unethical actions
- Cultural and spiritual diversity of patients and staff as relates to health care needs
- Patient-centered care and shared decision making
- Ethical implications of human- or animal-subject research
- Research enterprise initiatives
- Ethics committees' roles- structure- and functions
- Patients' rights and responsibilities (e.g.- informed consent- withdrawal of care- advance directives)
- Professional standards- licensure- board certification- code of conduct
- Educational program integration and continuing education
- Staff
- Medical Professionals
- Role modeling professionalism in the learning environment
- Strategies for management of the disruptive physician
- Organizational policies on misinformation
- Medical marijuana