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The Jade Health Plan used a profitability index (PI) to rank the following capital proposals:
Proposal PI
A0.45
B1.05
This information indicates that, of these two projects, Jade would most likely select:
Provider reimbursement methods that transfer some utilization risk from a health plan to providers affect the health plan's RBC formula. A health plan's use of these reimbursement methods is likely to result in
A health plan that capitates a provider group typically provides or offers to provide stop-loss coverage to that provider group.
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