AHIP AHM-520 Exam With Confidence Using Practice Dumps

Are locked into a plan for a 12-month period, whereas enrollees from the commercial population may disenroll from a plan on a monthly basis

Require less enrollee education than do enrollees from the commercial population

Have higher incidences of chronic illness than do enrollees from the commercial population

Are enrolled in a health plan through a group situation, whereas the commercial population typically enrolls in a health plan on an individual basis

Causes Dr. Meyer's capitation contract with Cardigan to transfer more risk to him than the contract otherwise would transfer

Specifies that Cardigan will pay Dr. Meyer under an arrangement other than capitation until a specified number of children covered by the plan use him as their PCP

Both A and B

A only

B only

Neither A nor B

The net effect of using provider reimbursement contracts to transfer risk is that the health plan’s net worth requirement increases.

Once the health plan has transferred utilization risk to its providers, it is relieved of the legal obligation to provide medical services to plan members in the event of the provider’s insolvency.

The greater the amount of risk the health plan transfers to providers, the larger the credit-risk factor becomes in the health plan’s RBC formula.

By decreasing its utilization risk, the health plan increases its underwriting risk.