Managed Risk Agreement

The plans receive a monthly capitulation, i.e. a premium that the State pays to the MCO on behalf of each participant to cover the costs of providing the covered services. The State shall make the payment, whether or not the beneficiary concerned receives services during the period covered by the payment. plans are financially exposed to losses if they spend more on services and health management than they are paid for by the state; Conversely, they can withhold a portion of overpayments for profit or reinvestment, provided they spend at least a certain amount, called the medical loss rate, on medical care and other quality-enhancing activities. Customers can find a lot of value in having a managed service agreement with a particular provider. A properly prepared agreement gives a degree of certainty that customers can rely on the supplier to solve their problem. . . .