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Dr Michelle Kubiak Has Contracted with the Gem Health Plan

Question 194

Multiple Choice

Dr. Michelle Kubiak has contracted with the Gem Health Plan, a Medicare+Choice health plan, to provide medical services to Gem's enrollees. Gem pays Dr. Kubiak $40 per enrollee per month for providing primary care. Gem also pays her an additional $10 per enrollee per month if the cost of referral services falls below a targeted level. This information indicates that, according to the substantial financial risk formula, Dr. Kubiak's referral risk under this contract is equal to:


A) 20%, and therefore this arrangement puts her at substantial financial risk
B) 20%, and therefore this arrangement does not put her at substantial financial risk
C) 25%, and therefore this arrangement puts her at substantial financial risk
D) 25%, and therefore this arrangement does not put her at substantial financial risk

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