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reimbursement: risk


The chance or possibility of loss. For example, physicians may be held at risk if hospitalization rates exceed agreed-upon thresholds. The sharing of risk is often employed as a utilization control mechanism within the HMO setting. Risk is also defined in insurance terms as the probability of loss associated with a given population.*

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*Extracted from Family Physicians and Managed Care: A View to the 90's: (paperback 1993) with permission from American Academy of Family Physicians



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