AHIP AHM-520 Exam - Topic 2 Question 98 Discussion

Actual exam question for AHIP's AHM-520 exam

Question #: 98
Topic #: 2

Three general strategies that health plans use for controlling types of risk are risk avoidance, risk transfer, and risk acceptance. The following statements are about these strategies. Three of these statements are true, and one statement is false. Select the answer choice containing the FALSE statement.

AGenerally, the smaller the likely benefits of accepting a risk, and the lower the costs of avoiding that risk, the greater the likelihood that a health plan will elect to avoid the risk.

BA health plan is seldom able to transfer any of the risk that utilization rates will be higher than expected and that its cost of providing healthcare will exceed the revenues it receives.

CIf a risk is a pure risk from the point of view of a health plan, then the health plan most likely will attempt to avoid the risk.

DA health plan would most likely transfer some or all of its utilization risk if it pays a provider a rate that is based on the number of plan enrollees that choose the provider as their primary care provider (PCP).

Show Suggested Answer

Suggested Answer: A

by Gearldine at Sep 17, 2024, 08:15 AM

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Serina

5 months ago

I agree with C, avoiding pure risks is a common strategy.

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Jess

5 months ago

D is surprising, I didn't know they could transfer utilization risk like that!

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Nu

6 months ago

C seems right, pure risks are usually avoided.

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Tom

6 months ago

I think B sounds off, they can transfer some risk.

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Sharen

6 months ago

A is definitely true, makes sense!

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Isaac

6 months ago

I’m leaning towards D being the false statement. It feels like a health plan would want to transfer risk in that scenario, but I need to double-check my notes.

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Noelia

7 months ago

Statement A seems tricky. I feel like the relationship between benefits and costs is important, but I can't recall the exact details.

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Emilio

7 months ago

I think statement B sounds off. We talked about how health plans can transfer risk, especially with higher utilization rates.

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Lavonne

7 months ago

I remember discussing risk avoidance in class, but I'm not sure if the statement about pure risk is accurate. It seems like it could go either way.

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Jenifer

7 months ago

Alright, I think I've got a handle on this. The key is to understand how health plans typically approach these different risk management strategies. I'm leaning towards one of the statements being an exception to the general patterns, so I'll need to analyze each one closely.

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Goldie

7 months ago

I'm a little unsure about this one. The concepts of risk avoidance, transfer, and acceptance can be tricky to apply in specific situations. I'll need to reread the options carefully and try to identify which one seems least aligned with the general principles.

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Lang

7 months ago

Okay, let's see here. The first statement about the likelihood of risk avoidance seems reasonable. The second one about not being able to transfer utilization risk also makes sense. The third one about avoiding pure risks is a good strategy. The fourth one about transferring utilization risk to providers is interesting - I'll have to think about that one.

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Rebeca

7 months ago

Hmm, this question is asking me to identify the false statement about the three risk management strategies. I'll need to carefully read through each option and think about which one doesn't align with the descriptions of risk avoidance, risk transfer, and risk acceptance.

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Susy

12 months ago

I bet the health plan actuaries behind these strategies have a lot of 'risk' in their job titles. Talk about a high-stakes career!

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Marge

12 months ago

Ha, this exam is really making me think! Glad I'm not the one who has to come up with these tricky questions.

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Irving

11 months ago

C) If a risk is a pure risk from the point of view of a health plan, then the health plan most likely will attempt to avoid the risk.

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Bulah

11 months ago

B) A health plan is seldom able to transfer any of the risk that utilization rates will be higher than expected and that its cost of providing healthcare will exceed the revenues it receives.

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Dusti

11 months ago

A) Generally, the smaller the likely benefits of accepting a risk, and the lower the costs of avoiding that risk, the greater the likelihood that a health plan will elect to avoid the risk.

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Jesus

12 months ago

I'm not sure, but I have a feeling option C is the false one. Pure risks are usually insurable, so health plans might actually accept them rather than avoid them.

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Ardella

11 months ago

So, the false statement is probably not option C.

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Murray

12 months ago

I agree, health plans might actually accept pure risks rather than avoid them.

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Theodora

12 months ago

I think you might be right, pure risks are usually insurable.

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Latricia

1 year ago

Option D seems like the correct answer to me. Transferring utilization risk to providers who are paid based on the number of enrollees they serve is a common strategy for health plans.

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Kate

11 months ago

I agree with you, option D is the correct answer. Transferring utilization risk to providers is a common strategy for health plans.

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Lizette

11 months ago

I believe option B is the false statement. Health plans can transfer some of the risk of higher utilization rates to providers.

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Sunshine

12 months ago

I think option A is the false statement. Health plans are more likely to avoid risks with high costs and low benefits.

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Erasmo

1 year ago

I think option B is the false statement. Health plans can actually transfer some of the risk of higher-than-expected utilization to providers through various payment models like capitation or shared risk arrangements.

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