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economics for healthcare managers

Questions and Answers of Economics For Healthcare Managers

A not-for-profit hospital realizes a 3 percent return on its $200,000 investment in its home health unit. Its current revenue after discounts and allowances is $382,000. Administrative costs are
A clinic has $1 million in revenues and $950,000 in costs. What is its operating margin?
Kim and Pat underwrite insurance. Each underwrites 50 accounts per month. Each account takes four hours to underwrite. The value of their time is $40 per hour. Monthly costs for each are $1,500 for
Why did hospitals have limited incentives to reduce readmissions before the ACA?
What are some examples of modifiable social determinants of health that would be feasible for an ACO to influence? For a health system not in an ACO? For an insurer?
You have incurred a medical bill of $10,000. Your plan has a deductible of $1,000 and coinsurance of 20 percent. How much of this bill will you have to pay directly?
Why do employers provide health insurance coverage to their employees?
You were given a lottery ticket. The drawing will be held in 5 minutes. You have a 0.1 percent chance of winning $10,000. You refuse an offer of $11 for your ticket. Are you risk averse? Explain.
Your practice offers only a PPO with a large deductible, high coinsurance, and a limited network. You pay $400 per month for single coverage. Some of your employees have been urging you to offer a
What are the fundamental differences between HMO and PPO plans?
Five of ten people earn $0, four earn $100, and one loses $100. What is the expected payoff? What is the variance of the payoff?
You have a 1 percent chance of having healthcare bills of $100,000, a 19 percent chance of having healthcare bills of $10,000, a 60 percent chance of having healthcare bills of $500, and a 20 percent
Suppose that your employer offered you $4,000 in cash instead of health insurance coverage. Health insurance is excluded from state income taxes and federal income taxes. (To keep the problem simple,
Medicare Advantage (private insurance for Medicare beneficiaries) presents major risks for insurers. First, the Centers for Medicare & Medicaid Services annually compiles performance data and assigns
The University of Pittsburgh Medical Center (UPMC) has international operations in nine countries (UPMC 2017a). It operates cancer centers and a full-service hospital in Ireland; transplantation,
You have a 1 percent chance of having healthcare bills of $100,000, a 19 percent chance of having healthcare bills of $10,000, a 60 percent chance of having healthcare bills of $500, and a 20 percent
You have a 2 percent chance of having healthcare bills of $100,000, a 20 percent chance of having healthcare bills of $10,000, a 60 percent chance of having healthcare bills of $500, and an 18
You have a 50 percent chance of making $0, a 40 percent chance of making $100, and a 10 percent chance of losing $100. Calculate the expected value and variance of the payoff. How does your estimate
Your firm faces considerable revenue uncertainty because you have to negotiate contracts with several customers. You forecast a 20 percent chance that your revenues will be $200,000, a 30 percent
Your firm rents a supply management system to hospitals. You have received a buyout offer of $5 million. You forecast a 25 percent chance that you will have profits of $10 million, a 35 percent
Your house is worth $200,000. Your risk of a catastrophic flood is 0.5 percent. Such a flood would destroy your house and would not be covered by homeowner’s insurance. Although you grumble, you
Instead of complete insurance as in exercise 4.5, you have a policy with a $5,000 deductible. What will your expected out-ofpocket spending be? What will your expected insurance benefits be? Assuming
Explain how a decrease in input prices or an increase in efficiency would affect costs.
Your firm has been sued for $3 million by a supplier for breach of contract. Your lawyers believe that three possible outcomes could occur if the suit goes to trial. One, which the lawyers term
The following data describe the costs for two pediatric clinics with the same revenue. Calculate the average and sample standard deviation of weekly costs. Which clinic is riskier? Week 1 2 3 4 5 6 7
Why does reducing cost variation reduce risk? Why does reducing fixed cost reduce risk?
You spent $500,000 on coding training last year. Is this a sunk cost? Should it be considered in making a decision whether to switch coding software?
In a week a clinic sees the following numbers of flu cases per day: 1, 2, 2, 4, 6. What is the average for this sample? What is the standard deviation for this sample?
Lean is a performance improvement strategy that emphasizes reducing waste, with waste defined as activity that adds less value than it costs. Examples of waste include patients’ waiting time (which
A Colorado woman took her daughters to what she thought was an urgent care clinic in a shopping mall (Olinger 2015). Both were treated for respiratory problems, and the visit went well. “I thought
Baptist Health System, a clinically integrated network of five hospitals in Texas, has taken part in Medicare’s knee replacement bundled payment programs since 2008. Medicare began bundled payments
Sweetwater Nursing Home has 150 beds. Its cost and volume data are as follows. Calculate its average and marginal costs for volumes ranging from 100 to 140. What patterns do you see?
A community health center has assembled the following data on cost and volume. Calculate its average and marginal costs for volumes ranging from 25 to 40. What patterns do you see?
You bought two acres of land for $200,000 ten years ago. Although it is zoned for commercial use, it currently holds eight small, singlefamily houses. A property management firm that wants to
A clinic’s cost and visit data are as follows. Calculate its average and marginal costs. Note that you can only calculate marginal cost as visits increase from 100 to 110. Visits 100 110 Total
Use the data in exercise 5.8. How would the average and marginal costs change if the phlebotomist’s wage rose to $24 per hour? What principle does your calculation illustrate?Exercise 5.8A
A phlebotomist takes 15 minutes to complete a blood draw. The supplies for each draw cost $4, and the phlebotomist earns $20 per hour. The phlebotomy lab is designed to accommodate 20,000 draws per
A practice uses $40 worth of a dentist’s time, $30 worth of a hygienist’s time, $10 worth of supplies, and $15 worth of a billing clerk’s time to produce a visit. The practice charges a patient
A new computer lets a phlebotomist complete a blood draw in 10 minutes. The supplies for each draw cost $4, and the phlebotomist earns $20 per hour. The phlebotomy lab is designed to accommodate
Use the data in exercise 5.8. How would the average and marginal costs change if the rent rose to $100,000? What principle does your calculation illustrate?Exercise 5.8A phlebotomist takes 15 minutes
A patient visits a clinic. She incurs $10 in travel costs and has a copayment of $20. The clinic’s total charge is $60. The clinic spends $9 to bill the insurance company for the visit and uses
A PCMH emphasizes a team approach to care, typically including physicians, advanced practice nurses, physician assistants, nurses, pharmacists, nutritionists, social workers, educators, and care
An insurance market consists of high-risk patients, who average $40,000 in spending per year, and low-risk patients, who average $1,000 per year. Overall, low-risk patients represent 90 percent of
It is easy to understand why JetBlue Airlines helped to establish the Employers Centers of Excellence Network. JetBlue and its partners shifted from paying highly variable prices for care of variable
This question actually has two parts, because cost has several meanings. Moving to Medicare for all would reduce administrative costs for insurers and providers. Overall, private insurers’
If Kim and Pat from exercise 5.14 merge their operations, they would need only one receptionist, and their rent for the joint office would be $2,800 per month. All other values stay the same.
Refer to exercise 6.1. If an insurer sold 100,000 policies at $6,000, what would revenue be? What would medical costs be if the insurer paid for everything and low-risk patients were 90 percent of
Where are reference prices being used? What have their effects been?
Why would a system launch a medical home that is intended to reduce its revenues?
Go to the Centers for Medicare & Medicaid Services Innovation Center website (https:// innovation.cms.gov) and see what ideas are being tested in a state of your choice.
What recent evidence about the performance of ACOs can you find? Are they growing? Are they saving money? Do enrollees seem to like the care they get? Is the quality of care good?
What recent evidence about medical homes can you find? Are they growing? Are they saving money? Do enrollees seem to like the care they get? Is the quality of care good?
What recent evidence about bundled payment programs can you find? Are they growing? Are they saving money? Do enrollees seem to like the care they get? Is the quality of care good?
What risk does a health system bear when it agrees to a bundled payment?
How much did cost per Medicare beneficiary go up last year? The Kaiser Family Foundation publishes these data (www.kff.org/ state-category/medicare/).
What recent evidence about Medicare Advantage HMOs can you find? Are they growing? Are they saving money? Do enrollees seem to like the care they get? Is the quality of care good?
How are a narrow network and an ACO different?
What risk does a health system bear when it agrees to accept capitation?
Why would a health system want to participate in a trial of bundled payments?
Is the idea of demand useful in healthcare, given the important role of agents?
Mentioning a nationwide shortage of primary care providers, millions of patients newly insured through the Affordable Care Act, and an aging population, Andrew Sussman, MD, president of CVS’s
Why might a consumer be “rationally ignorant” about the proper therapy for gallstones?
Why do demand curves slope down (i.e., sales volume usually rises at lower prices)?
Why would consumers ever choose insurance plans with large deductibles?

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