Discuss AHIP AHM-520 Exam Topic 1 Question 82

A health plan may experience negative working capital whenever healthcare expenses generated by plan members exceed the premium income the health plan receives.

Ways in which a health plan can manage the volatility in claims payments, and therefore reduce the risk of negative working capital, include:

1. Accurately estimating incurred but not reported (IBNR) claims

2. Using capitation contracts for provider reimbursement

ABoth 1 and 2

B1 only

C2 only

DNeither 1 nor 2

Suggested Answer: A

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27 comments · newest first

Gregoria 11 months ago

I thought IBNR was just a guess, how can it be accurate?

Shawna 11 months ago

Both methods are essential for stability in health plans.

Gerry 12 months ago

Wait, can capitation really reduce negative working capital?

Karol 12 months ago

Totally agree, capitation can really help manage costs.

Billy 1 year ago

IBNR claims are super tricky to estimate!

Owen 1 year ago

I’m a bit confused; I thought IBNR was crucial, but I’m not sure if capitation alone could suffice. Maybe I should go with option B?

Romana 1 year ago

I practiced a similar question about managing claims volatility, and I feel like both options might be valid, but I’m leaning towards option A.

Francoise 1 year ago

I think using capitation contracts can really help manage costs, but I can't recall if estimating IBNR is also essential for reducing negative working capital.

Ariel 1 year ago

I remember studying IBNR claims and how important they are for financial forecasting, but I'm not entirely sure if both strategies are necessary.

Lettie 1 year ago

This question seems pretty straightforward to me. The two ways mentioned - IBNR estimates and capitation contracts - are both well-known strategies for managing claims volatility and working capital risk. I'll just need to make sure I explain how each one works to achieve that goal.

Ty 1 year ago

Okay, I think I've got this. The key is that accurately estimating IBNR claims allows the health plan to better anticipate and plan for upcoming expenses. And using capitation contracts shifts more of the financial risk to providers, which can help stabilize the health plan's cash flow. I'll make sure to explain those points clearly in my answer.

Jennifer 1 year ago

Hmm, I'm a little unsure about this one. The question is asking about ways to manage volatility in claims payments, but I'm not totally clear on how IBNR claims and capitation contracts specifically help with that. I'll need to think through the connections more carefully.

Delila 1 year ago

This seems like a straightforward question about managing working capital in a health plan. I'll focus on understanding the key ways to reduce the risk of negative working capital, like accurately estimating IBNR claims and using capitation contracts.

Mabel 1 year ago

Hmm, I'm not sure about this one. The wording is a bit tricky. I'll need to think it through carefully.

Kimbery 1 year ago

I think we discussed that EPP is usually for traditional anti-malware, so maybe D is the right choice for advanced detection?

Andrew 1 year ago

I think this question is asking about the definition of "Urban Service Areas", which sounds like it's referring to a specific planning concept. I'll need to think carefully about the key details in the answer choices to determine which one best matches that definition.

Val 1 year ago

I'm a little confused by the wording of these options. I'll need to think through each one carefully to determine which is the most accurate statement.

Leonardo 1 year ago

Ah, I remember learning about this in class. The distribution's package repository is the recommended way to install new applications on a Linux system. That's the most secure and up-to-date option.

Isreal 2 years ago

So, the answer would be both Lillian and Telma, right?

Venita 2 years ago

Another way is using capitation contracts for provider reimbursement. That's option Telma.

Delbert 2 years ago

One way is accurately estimating incurred but not reported claims. That's option Lillian.

Xuan 2 years ago

So, what are the ways a health plan can manage this risk?

Telma 2 years ago

I agree. If expenses exceed income, it can lead to negative working capital.

Lillian 2 years ago

I think managing the volatility in claims payments is crucial for a health plan.

Mireya 2 years ago

I'm not too sure about that. I think the answer might be C) 2 only.

Una 2 years ago

I agree with Coral. Managing incurred but not reported claims and using capitation contracts can help reduce risk.

Coral 3 years ago

I think the answer is A) Both 1 and 2.

AHIP AHM-520 Exam - Topic 1 Question 82 Discussion