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Bay Pines Medical Center estimates that a capitated population of 50,000

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Bay Pines Medical Center estimates that a capitated population of 50,000 would have the following base utilization and the total cost characteristics;Inpatient Days Average Cost;Service Category per 1,000 Enrollees per Day;General 150 $1,500;Surgical 125 1,800;Psychiatric 70 700;Alcohol/Drug abuse 38 500;Maternity 42 1,500;Total 425 $1,367;In addition to medical costs, Bay Pines allocates 10 percent of total premium for administration/reserves.;a. What is the PMPM rate that Bay Pines must set to cover medical cost plus administration expenses?;b. What would be the rate if a utilization management program would reduce utilization within each patient service category by 10%/ By 20%?;c. Return to the initial case utilization assumption. What rate would be set if the average cost on each service were reduced by 10%?;d. Assume that both utilization and cost reductions were made. What would be premium be?;Additional Requirements;Min Pages: 3;Level of Detail: Show all work;Other Requirements: This deals with pricing and servicing decission

 

Paper#25091 | Written in 18-Jul-2015

Price : $22
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