Under a risk contract, medicare risk program is a federally qualified hmo or cmp that meets specified medicare requirements and provides medicare-covered services.
Medicare-covered services are delivered under a risk contract by federally approved HMOs and competitive medical plans (CMPs) that adhere to certain Medicare regulations.
A risk contract is an agreement between providers to offer Medicare beneficiaries capitated (fixed, payed basis) health care services. A risk contract is, in general, any agreement that leads to one party taking on financial or economic risk.
In the context of health care, this often means that if an employer, health plan, or provider accepts risk, they are committing to pay for additional use above and above the estimated expenses or payment offered.
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