When Congress passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), “risk” moved front and center as a feature of provider reimbursement models. These days, terms such as “at risk” and “risk-based” are used more and more, but what do they really mean? And why should healthcare providers now be more concerned with risk than they have been in years past?

Merriam-Webster defines risk as “the possibility that something bad or unpleasant (such as an injury or a loss) will happen.” In the current healthcare environment, risk could be defined as a loss of revenue: Providers and payers are risking income when they provide services to patients. The question has become, when treatments involve expensive services, drugs, or procedures, who will pick up the check?

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