AHM-520 Exam Dumps : Health Plan Finance and Risk Management

The types of financial risks and costs to which a health plan is subject depends on whether the health plan provides services to the Medicare and/or Medicaid populations or to the commercial population. One distinction between providing services to the Medicare and Medicaid populations and to the commercial population is that Medicare and Medicaid enrollees typically:

A health plan that capitates a provider group typically provides or offers to provide stop-loss coverage to that provider group.

Variance analysis is the study of the difference between expected results and actual results. Variances can be positive or negative. A positive variance is typically considered: