AHIP Exam AHM-520 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).

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Suggested Answer: A

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

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Susy

18 days 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

21 days 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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Dusti

1 days 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

25 days 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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Murray

13 days ago

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

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Theodora

16 days ago

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

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Latricia

1 months 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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Lizette

7 days 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

22 days 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 months 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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