7.5 Bay Pines Medical Center estimates that a capitated population of 50,000 would have the following base case utilization and total cost characteristics;Service Category Inpatient Days per 1,000 Enrollees Average Cost 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 the total premium for administration/reserves.;a. What is the PMPM rate that Bay Pines must set to cover medical costs plus administrative expenses?;b. What would be the rate if a utilization management program would reduce utilization within each patient service category by 10 percent? By 20 percent?
Paper#28730 | Written in 18-Jul-2015Price : $37