The hospital admits 500 patients per month (Q) who stay an average of five (4.5) days per admission, charges $12,000 per admission (P) and incurs $7,000 in costs (ATC) per patient. First, assume all patients are reimbursed under the same reimbursement method, complete the table and calculate net income for the hospital under each reimbursement method. Second, in the composite column calculate the hospital’s expected net income given the payer mix specified below (% of admissions). Assume the per diem payer is offering a contract for the upcoming fiscal year that will pay $1,400 per day, should the contract be accepted? Explain your answer.
80% of Charges, 35% of admissions
Cost, 5% of admissions
Per Diem, $1,600 per day, 10% of admissions
Per Case, use DRG payment calculated in #2, 45% of admissions
PMPM, $200 capitation for 15,000 covered lives, 5% of admissions
Charge Cost Per Diem Per Case Capitation Composite
Total Revenue $ _______ _______ _______ _______ _______ _______
- Contr. Disc. _______ _______ _______ _______ _______ _______
Net Revenue _______ _______ _______ _______ _______ _______
- Expenses _______ _______ _______ _______ _______ _______