AHIP AHM-520 Valid Dump : Health Plan Finance and Risk Management

AHM-520 real exams

Exam Code: AHM-520

Exam Name: Health Plan Finance and Risk Management

Updated: Oct 20, 2026

Q & A: 215 Questions and Answers

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Health Plan Finance and Risk Management AHM-520 Exam

Health Plan Finance and Risk Management AHM-520 Exam is designed by the Academy of Health Care Administration (AHM) and sponsored by the US Health Insurance Plans and the Blue Cross Blue Shield Association. AHM is a self-study examination based program. AHM-520 Exam validates candidate has the ability to get a comprehensive look at the Health Insurance Plan Fund. This exam also verifies the candidate has a strong understanding of financial management techniques, funds, risk management, provider payment, project risk, pricing, care, and rating methods.

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What is the duration of the AHM-520 Exam

  • Format: Multiple choices, multiple answers
  • Number of Questions: 215
  • Length of Examination: 90 minutes

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

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AHIP AHM-520 Exam Syllabus Topics:

SectionObjectives
Topic 1: Risk Management in Health Plans- Utilization and cost control strategies
  • 1. Managed care cost containment tools
    • 2. Provider reimbursement models (capitation, FFS, bundled payments)
      - Insurance risk concepts
      • 1. Risk pooling and transfer mechanisms
        • 2. Underwriting principles in managed care
          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- Health insurance revenue streams and premium structures
                  • 1. Membership and enrollment impact on revenue
                    • 2. Premium development basics
                      - Cost accounting in health plans
                      • 1. Medical cost classification
                        • 2. Administrative vs medical expense allocation
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