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AHIP AHM-520 Exam Braindumps - in .pdf Free Demo

  • Exam Code: AHM-520
  • Exam Name: Health Plan Finance and Risk Management
  • , Last Updated: Sep 09, 2026
  • Q & A: 215 Questions and Answers
  • Convenient, easy to study. Printable AHIP AHM-520 PDF Format. It is an electronic file format regardless of the operating system platform. 100% Money Back Guarantee.
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  • Exam Code: AHM-520
  • Exam Name: Health Plan Finance and Risk Management
  • , Last Updated: Sep 09, 2026
  • Q & A: 215 Questions and Answers
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The Health Plan Finance and Risk Management AHM-520 Exam certification path includes only one AHM-520 certification exam.

Reference: https://www.ahip.org/courses/health-plan-finance-and-risk-management-ahm520

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AHM-520 Exam Reference

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AHIP AHM-520 Exam Syllabus Topics:

SectionObjectives
Topic 1: Risk Management in Health Plans- Utilization and cost control strategies
  • 1. Provider reimbursement models (capitation, FFS, bundled payments)
    • 2. Managed care cost containment tools
      - Insurance risk concepts
      • 1. Underwriting principles in managed care
        • 2. Risk pooling and transfer mechanisms
          Topic 2: Health Plan Payment and Reimbursement Systems- Value-based payment models
          • 1. Pay-for-performance programs
            • 2. Shared savings models
              - Provider payment methodologies
              • 1. Capitation and risk adjustment basics
                • 2. Fee-for-service reimbursement
                  Topic 3: Health Plan Financial Fundamentals- Cost accounting in health plans
                  • 1. Medical cost classification
                    • 2. Administrative vs medical expense allocation
                      - Health insurance revenue streams and premium structures
                      • 1. Membership and enrollment impact on revenue
                        • 2. Premium development basics

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