AHIP AHM-520 Exam Practice Questions (P. 4)

Over time, health plans and their underwriters have gathered increasingly reliable information about the morbidity experience of small groups.
Generally, in comparison to large groups, small groups tend to:

In order to calculate a simple monthly capitation payment, the Argyle Health Plan used the following information:
The average number of office visits each member makes in a year is two
The FFS rate per office visit is $55
The member copayment is $5 per office visit
The reimbursement period is one month
Given this information, Argyle would correctly calculate that the per member per month (PMPM) capitation rate should be:

The Landau health plan will switch from using top-down budgeting to using bottom-up budgeting. One potential advantage to Landau of making this switch is that, compared to top-down budgeting, bottom-up budgeting is more likely to:

Correct statements about the financial risks associated with benefits that health plans provide to the Medicare and Medicaid markets include:

Ways in which a company can increase its return on investment (ROI) include:
1. Reducing expenses to increase operating income
2. Increasing controllable investment