In contract management, if a plan or provider underestimates the utilization for the population they are serving, the outcome will be a negative one in that the utilization will be higher than projected, and the plan or provider loses money.

Question

Quizplus · Accepted Answer

Underestimating utilization means the plan or provider expects lower usage of services than what actually occurs. This leads to higher costs than anticipated, potentially resulting in financial losses if the payments received do not cover these higher costs.

In Contract Management, If a Plan or Provider Underestimates the Utilization