Health plan premium. If a health plan covers 150,000 lives, expects 25 myocardial infarctions (MIs) to occur

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Health plan premium. If a health plan covers 150,000 lives, expects 25 myocardial infarctions

(MIs) to occur each year within the covered lives, expects a length of stay of 4.5 days for each MI, and has to pay an average of $950 per day for each day the MI patient is in the hospital, what is the PMPM cost to the health plan? What would have to be charged to the patient or employer if the health plan has administrative costs equaling 10 percent of its costs and it wants a profit margin of 7 percent?

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Financial Management Of Health Care Organizations

ISBN: 9781118466568

4th Edition

Authors: William N. Zelman, Michael J. McCue, Noah D. Glick, Marci S. Thomas

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