1. You have been asked to develop a capitation rate for a primary care group based on the following projections:
Service Annual Frequency/1,000 Cost per Service
Inpatient Visits 100 $7,000.00
Office Visits 3,000 $45.00
Lab/X-ray 500 $25.00
What per-member per-month (PMPM) rate would be required to break even, ignoring any copayments?
Use the information from the previous problem.. Assume that you are the hospital administrator and that the health plan has offered you a capitated contract at the PMPM rate that you computed in problem 18. You believe, however, that you can control utilization better than is reflected in the table above. You believe the actual utilization will be 370 per 1,000 persons. The number of covered lives is 25,000. Your cost per case is $1,100. (For purposes of this problem, ignore marginal costs, contribution margins, etc.. What is the hospital's total revenue from this contract?. Would your hospital realize a profit on this contract? use a copay PMPM of 33.33 to complete 2 last questions