Question
#11. Bay Pine Medical Center estimates that a capitated population of 50,000 would have the following base case utilization and total cost characteristics: In addition
#11. Bay Pine Medical Center estimates that a capitated population of 50,000 would have the following base case utilization and total cost characteristics: In addition to medical costs, Bay Pines allocated 10% of the total premium for administration /reserves.
In addition to medical costs, Bay Pines allocated 10% of the total premium for administration /reserves.
(Service Category)
Inpatient Days per 1,000 Enrollee : General 150 , Surgical 125 , Psychiatric 70 , Alcohol / Drug Abuse 38 , Maternity 42
Average Cost per Day : General $1,500 , Surgical $1,800 , Psychiatric $700 , Alcohol / Drug Abuse $500 , Maternity $1,500
Total 425 $1,367
What is the PMPM rate that Bay Pines must set to cover medical costs and administrative expenses? Remember that "Inpatient Days" is per 1,000 enrollees. Also, the entire capitated population is 50,000.
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