Answered step by step
Verified Expert Solution
Question
1 Approved Answer
All America HMO pays its primary care physicians (PCPs) by capitation, but a percentage of the total capitated amount is withheld and distributed to individual
All America HMO pays its primary care physicians (PCPs) by capitation, but a percentage of the total |
capitated amount is withheld and distributed to individual PCPs based on aggregate PCP performance. |
The financial goal of importance to All America is to achieve total actual specialty care and hospital |
costs less than budgeted. To this end, All America provides a financial incentive to its PCPs to |
encourage careful referral of patients to these services. The financial incentive is based on the referral |
gain or loss, defined as the difference between the actual and budgeted specialty care and hospital cost. |
More specifically, All America uses the following risk-sharing rules: |
Last year, All America's capitation payment to the PCPs was $20 PMPM, but 15 percent of this |
amount was placed into the PCP risk pool. The budgeted amount for specialty and hospital costs was |
$50 PMPM. At the end of the year, the following data were recorded for the four All America PCPs: |
a. Calculate the total compensation of each PCP at the end of the year. |
|
Step by Step Solution
There are 3 Steps involved in it
Step: 1
Get Instant Access to Expert-Tailored Solutions
See step-by-step solutions with expert insights and AI powered tools for academic success
Step: 2
Step: 3
Ace Your Homework with AI
Get the answers you need in no time with our AI-driven, step-by-step assistance
Get Started