Assume that both utilization and cost reductions were made. What would the premium be?
Bay Pines Medical Center estimates that a capitated population of 50000 would have the following ba Show more Bay Pines Medical Center estimates that a capitated population of 50000 would have the following base case utilization and total cost characteristics: Service Category Inpatient Days per 1000 Enrollees Average Cost per Day General 150 $1500 Surgical 125 $1800 Psychiatric 70 $700 Alcohol/Drug Abuse 38 $500 Maternity 42 $1500 Total 425 $1367 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? c.) Return to the initial base case utilization assumption. What rate would be set if the average cost on each service were reduced by 10 percent? d.) Assume that both utilization and cost reductions were made. What would the premium be?
“Looking for a Similar Assignment? Order now and Get a Discount!
The post Assume that both utilization and cost reductions were made. What would the premium be? appeared first on Premium Academic Affiliates.
