Problem:
Please work out the following questions and upload your work. You may type your work and submit a document, but it may be easier to write it out and upload a picture. Be sure to make your answer noticeable. A nursing home contracts with an HMO for skilled nursing care at $2.00 PMPM. If costs are expected to average $120 per day, what is the maximum utilization of days per 1,000 members that the nursing home can experience before it begins to lose money? An HMO has a point-of-service (POS) option for its members but will pay only 80% of approved charges. If a member goes out of network for a medical procedure with a charge of $2,000, of which $1,200 is approved, how much must the member pay? Need Assignment Help?