AHIP AHM-520 Exam - Topic 4 Question 4 Discussion
The following statements are about risk management in health plans. Select the answer choice containing the correct response.
D) A health plan generally structures its risk management process around loss reduction techniques and loss transfer techniques.
A) Risk management is especially important to health plans because the Employee Retirement Income Security Act of 1974 (ERISA) allows plan members to recover punitive damages from healthcare plans.
B) With regard to the relative risk for health plan structures based upon the degree of influence and relationships that health plans maintain with their providers, preferred provider organizations (PPOs) typically have a higher risk than do group HMOs and staff HMOs.
C) Although there are clear risks associated with the provision of healthcare services and coverage decisions surrounding that care, the bulk of risk in health plans is associated with a health plan's benefit administration and contracting activities.
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