AHIP Exam AHM-530 Topic 2 Question 7 Discussion

Actual exam question for AHIP's AHM-530 exam

Question #: 7
Topic #: 2

Dr. Michelle Kubiak has contracted with the Gem Health Plan, a Medicare+Choice health plan, to provide medical services to Gem's enrollees. Gem pays Dr. Kubiak $40 per enrollee per month for providing primary care. Gem also pays her an additional $10 per enrollee per month if the cost of referral services falls below a targeted level. This information indicates that, according to the substantial financial risk formula, Dr. Kubiak's referral risk under this contract is equal to:

A20%, and therefore this arrangement puts her at substantial financial risk

B20%, and therefore this arrangement does not put her at substantial financial risk

C25%, and therefore this arrangement puts her at substantial financial risk

D25%, and therefore this arrangement does not put her at substantial financial risk

Show Suggested Answer

Suggested Answer: B

by Reena at May 05, 2022, 04:37 PM

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