In a managed care plan, this phrase refers to a decrease of a risk (loss foreseen) in the group of members.

Situations that influence an individual’s health and may cause illness including heredity, sex, race, age, biological factors, environmental factors, and behavioral factors (smoking, inactivity, response to stress).

MEDICAL, US: Individual responsible for clinical and administrative procedures used to identify, evaluate, and reduce the risk of injury to patients, staff, and visitors and the risk of loss to the facility or organization.
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UK: Person appointed to carry out risk management on behalf of an industrial or other organisation. Risk managers may join the Association of Risk Managers in Industry and Commerce (AIRMIC) or the Institute of Risk Management or ALARM if in the public sector.
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Risk managers advise organizations on any potential risks to the profitability or existence of the company. They identify and assess threats, put plans in place for if things go wrong and decide how to avoid, reduce or transfer risks.
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The individual in an organization responsible for evaluation of the organization’s exposures and controlling those exposures through such means as avoidance or transference, as to an insurance company.

Risks are based on documentation of the presenting problem(s), the procedure(s) performed, treatments ordered, and other possible management options.

MEDICAL, US: 1. Individuals who comprise an insured group based on health status, age, sex, and future health. Also called risk spread . 2. State program that groups those who cannot obtain insurance coverage. Funds for these programs come from either the state or an assessment on insurers. 3. In managed care plans, a collection of funds established by a managed care plan that uses a risk-sharing system (i.e., capitation) with providers of medical services. Funds are taken from withholding a portion of provider fees or capitation payments to make up the reserve to cover unforeseen use of services. Funds that remain at the end of a year are distributed among the providers. Also called pool . 4. Financial account to which a managed care plan’s specific income and expenses are posted.
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Also known as a pool. A group of insurers (or reinsurers) who share the premiums and losses of a risk they have written together, according to an agreement that exists between them. A pool often writes large commercial risks.
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Multiple subjects of insurance insured or reinsured by a single insurer where, to avoid risk concentration and improve risk distribution, different combinations of exposures, perils, and hazards will be underwritten.

Classification system used by the insurance industry to set premiums for health plans. Insured individuals who have a high risk pay more than others who are insured because of their health-related behaviors.

Measurement of the costs of an enrollee who has specific risks compared with the cost of care for the average beneficiary in a managed care plan.