risk HMO
risk HMO
A health plan in the US which assumes insurance risk and receives a capitated payment for each enrollee, amounting to 95% of the average local payment for traditional Medicare.Pros
Risk HMOs save money for Medicare, provide expanded benefits, guarantee enrollment, and allow easy disenrollment.
Cons
Chronically ill patients may be at a disadvantage; aggressive marketing and inadequate appeals process may harm the unwary consumer.