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AHIP Health Plan Finance and Risk Management : AHM-520

AHM-520 Exam Simulator
  • Exam Code: AHM-520
  • Exam Name: Health Plan Finance and Risk Management
  • Updated: Jul 17, 2026
  • Q & A: 215 Questions and Answers
  • AHIP AHM-520 Q&A - in .pdf

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About AHIP AHM-520 Exam Simulator

Who should take the AHM-520 exam

  • Financial executives working with clients looking to maximize their health dollars
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  • Case administrators and medical directors who inquire a broader administrative background
  • Employees who work for health care providers or health insurance plans and want to get the educational background to proceed with a management position in the industry
  • Medical management employees working in hospitals, health systems, and, health insurance plans

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AHIP AHM-520 exam simulator

Certification Path

The Health Plan Finance and Risk Management AHM-520 Exam certification path includes only one AHM-520 certification exam.

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For more info visit:

AHM-520 Exam Reference

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

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AHIP AHM-520 Exam Syllabus Topics:

SectionObjectives
Health Plan Payment and Reimbursement Systems- Value-based payment models
  • 1. Shared savings models
    • 2. Pay-for-performance programs
      - Provider payment methodologies
      • 1. Fee-for-service reimbursement
        • 2. Capitation and risk adjustment basics
          Risk Management in Health Plans- Utilization and cost control strategies
          • 1. Provider reimbursement models (capitation, FFS, bundled payments)
            • 2. Managed care cost containment tools
              - Insurance risk concepts
              • 1. Risk pooling and transfer mechanisms
                • 2. Underwriting principles in managed care
                  Health Plan Financial Fundamentals- Cost accounting in health plans
                  • 1. Administrative vs medical expense allocation
                    • 2. Medical cost classification
                      - Health insurance revenue streams and premium structures
                      • 1. Membership and enrollment impact on revenue
                        • 2. Premium development basics

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