Healthcare Finance

A nursing Abode forms after a while an HMO for useful nursing anxiety at $3.00 PMPM. If absorbs are expected to mediocre $120 per day, what is the completion utilization of days per 1,000 members that the nursing abode can proof precedently it begins to promote money?

Please appearance all of your employment / calculations to accept reputation.

Part 2 -

Refer to the table under for collections 1-5. A hospital and a sanity plan are negotiating a form for inpatient medical–surgical care.             Calculate the amounts that would  complete the table under. (Please belong to paragraph 7 if essential).

Table: Per Member Per Month (PMPM) Rate

                                       Annual                                                                      

                                    Frequency        Unit                        Frequency        Copay        Copay         Net

Category                        per 1,000      Cost        PMPM       per 1,000       Amount      PMPM       PMPM

Hospital inpatient

Medical surgical                400        $1,000         (Q1)            100               $150         (Q2) (Q3)

Use the knowledge from interrogations 1 - 3 in solving interrogations 4 and 5. Assume that you are the hospital dignitary and that the  health    plan has offered you a capitated form at the PMPM objurgate that you computed in interrogation 1. You admire, so-far, that you can repress utilization improve than is reflected in the table overhead. You admire the explicit utilization procure be 370 per 1,000 beings. The calculate of expert lives is 25,000. Your absorb per event is $1,100. (For purposes of this collection, disown ultimate absorbs, assistance margins, etc.)

1. What is the PMPM objurgate?

2. What is the copay PMPM?

3. What is the NET PMPM?

4. What is the hospital’s sum fruits from this form?

5. Would your hospital reap a benefit-service on this form?

Please appearance all of your employment / calculations to accept reputation.

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