What does a risk contract establish?

A risk contract is an agreement between a healthcare provider and an insurance company that outlines the terms under which the provider is paid for services rendered, particularly in a capitated model. In this arrangement, the provider receives a fixed payment amount per patient, often referred to as capitated payments, for a specified range of healthcare services over a certain period. This payment structure incentivizes providers to manage healthcare delivery efficiently, focusing on preventative care and cost management to avoid unnecessary services while ensuring that patients receive appropriate care.

In contrast, the other options do not accurately reflect the core purpose of a risk contract. Uncompensated care does not relate to the financial arrangements found in risk contracts, and while methods for payer-provider communication can be a part of healthcare management, it does not capture the essence of what a risk contract establishes. Similarly, while there could be limits on patient treatment options in some healthcare models, a risk contract primarily focuses on capitated payment arrangements rather than directly dictating treatment limits. Thus, the option indicating capitated healthcare services for beneficiaries accurately characterizes the fundamental aspect of a risk contract.