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7 . 5 . Bay Pines Medical Center estimates that a capitated population of 5 0 , 0 0 0 would have the following base

7.5. Bay Pines 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 allocates 10 percent of
the total premium (total capitated revenue) for administration/
reserves.
a. What is the PMPM rate that Bay Pines must set to cover medical
costs plus administrative expenses?
b. What would be the rate if a utilization management program
were to reduce utilization within each patient service category by
10 percent? By 20 percent?
c. Return to the initial base case utilization assumption. What rate
would be set if the average cost on each service were reduced by
10 percent?
d. Assume that both utilization and cost reductions were made.
What would the premium hes
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