1. What are the four major activities of a health plan? Choose one activity and describe.
2. How is charity care defined?
3. Why is the unreimbursed cost of Medicare not included as an element of community benefit?
4. You have been asked to develop a capitation rate for a primary care group based on the following projection.
| Service |
Annual Frequency/1000 |
Cost per Service |
| Inpatient visits |
100 |
$7,000.00 |
| Office visits |
3000 |
$45.00 |
| Lab/X-ray |
500 |
$25.00 |
Define PMPM. What PMPM rate would be required to break even, ignoring any copayments?