Memorial Hospital is trying to calculate its expected payments from a proposed fee structure with a local
Question:
Memorial Hospital is trying to calculate its expected payments from a proposed fee structure with a local health plan. The health plan projects its hospital budget at 465 patient days per 1,000 members, with a payment rate of $1,000 per patient day. The covered population is 25,000 members, which produces a hospital budget of
$11,625,000 [(465/1,000) × 25,000 × $1,000)]. The health plan proposes that a 10% withhold be put into effect, which translates to an actual per diem payment of $900. The risk pool would be shared equally by the doctors
(one half ) and the hospital (one half ). Any negative balance in the risk pool would be assumed by the health plan.
Calculate the amount of payment to Memorial Hospital under two assumptions: 550 patient days per 1,000 and 430 patient days per 1,000.
Step by Step Answer:
Essentials Of Health Care Finance
ISBN: 9781284094633
8th Edition
Authors: William O. Cleverley, James O. Cleverley