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

The net effect of using provider reimbursement contracts to transfer risk is that the health plan’s net worth requirement increases.

Once the health plan has transferred utilization risk to its providers, it is relieved of the legal obligation to provide medical services to plan members in the event of the provider’s insolvency.

The greater the amount of risk the health plan transfers to providers, the larger the credit-risk factor becomes in the health plan’s RBC formula.

By decreasing its utilization risk, the health plan increases its underwriting risk.

Coral's equity holders have an ownership interest in the health plan

The interest that Coral pays on its debt most likely is not tax deductible to Coral

Coral's debt holders have no legal claim to Coral's assets

Equity is a more risky source of capital, from Coral's perspective, than is debt

Encourage Sunrise's physicians to perform services that are not medically necessary

Completely eliminate service risk for Sunrise's physicians

Decrease Sunrise's liability for any negligent acts of the physicians in the plan's network of providers

Help stabilize expenses for Sunrise