1) Dr. Robbins, a local pediatrician, accepts Red Square Insurance, a commercial insurance company, for payment. Since Dr. Robbins has agreed to accept a 20% discount off of their normal charges, Red Square has made Dr. Robbins a member of their preferred provider' list. If Dr. Robbins normally charges $100 per routine office visit (a pretty standard amount in the region), how much will Red Square reimburse Dr. Robbins for their member, little Suzy's office visit? B) What kind of reimbursement (payment) model is this? 2) Red Square is trying to convert as many of their providers to a capitated payment model. They have approached Dr. Robbins about providing pediatric services for their 7,000 pedi members. a. They have offered Dr. Robbins $4.00 PMPM. What would Dr. Robbins' monthly capitated revenue be? b. Red Square estimates that 2% of their pediatric patients have an office visit per month. Dr. Robbins has fixed costs of $15,000 per month that nijed to be covered and the VCu for an office visit is $95. Is this contract profitable for Dr. Robbins? C. What PMPM would Red Square need to offer Dr. Robbins for them to break even? 3) Up Country Primary Care Clinic provides routine diagnostic and treatment services for common illnesses. Assume they see 1000 patients per month for office visits. (We have not looked at data in this way in class. Think about what it is telling you and try to logic your way through it.) Payer Medicare Medicaid Commercial Insurance Charityon-paying % of patients 40% 20% 37% 3% Reimbursement $55 $20 $65 $0 A) What Is Up Country's total revenue per month? B) Assume that Up Country's fixed costs are $25000 per month and their variable costs are $10 per office visit. What is their monthly profit (loss)? C) What would happen to your profitability of the commercial insurance company changed their reimbursement rate to $50