Dual Risk

The dual-risk program is an optional program in which the participating physician group (PPG) establishes a capitated incentive arrangement with a primary hospital that is capitated and financially responsible for in-area hospital services provided to Health Net members. Hospitals are liable for in and out-of-area services up to the reinsurance limit. This program is only offered to a limited group of PPGs and hospitals.

The PPG must give Health Net a written description of incentive arrangements and any changes to the incentive arrangements within 60 calendar days of its establishment of any amendments.