Answered step by step
Verified Expert Solution
Link Copied!
Question
1 Approved Answer

Mr. Pasture was concerned about Green Guards profitability. Last year, Green Guard negotiated with Arc Electric to charge a fixed premium of $250 per employee

Mr. Pasture was concerned about Green Guard’s profitability. Last year, Green Guard negotiated with Arc Electric to charge a fixed premium of $250 per employee per month. The total premium revenue is allocated as follows: 55% to hospital and surgical services, 30% to physician visits, and 15% for other services, administration, and profit.

These allocations are used to establish budgets in the different departments at Green Guard. The Arc Electric contract would expire next month, at which time Green Guard would need to renegotiate the terms of its contract with Arc Electric. Mr. Pasture feared that Green Guard would have to request a sharp rate increase to remain profitable. Green Guard’s monthly cost of administering the health plan was fixed, but the increases in the use of health care services were eroding Green Guard’s profits. He suspected that other health plans were planning to increase premiums by 5-10 percent, which was reasonable given the recent statistics on national health expenditures. A report from 2004, the most recent he could find, indicated that total national health expenditures rose 7.9 percent from 2003 to 2004 -- over three times the rate of inflation.

Exhibit 1 Monthly Report of Health Care Utilization Total Costs Incurred - Arc Electric, Inc.

Category of ServiceJuly 2006August 2006
Hospital Services– Inpatient$203,425$212,250
Hospital Services – Outpatient$182,440$212,250
Surgical Services$101,250$103,400
Physician Office Visits$337,900$391,450
Administrative Expenses$90,000$90,000
TOTAL$915,015$977,800

Number of members, July 31, 2006: 4129

Number of members, August 31, 2006: 4137

Using only the information provided in Exhibit 1, explain why further analysis of physician visits may be needed. Compare the profitability of hospital and surgical services to physician services, using the allocation of revenue that was given. Show the breakdown of the $250 premium using a pie chart. Does the allocation of the $250 per employee per month payment across the types of health care services seem reasonable, given the past two months’ utilization?



Step by Step Solution

3.34 Rating (154 Votes )

There are 3 Steps involved in it

Step: 1

The total of August 2016 is wrong in this table It actually is 1009350 and all calculations below will be based on it While the total expenditure incr... blur-text-image
Get Instant Access to Expert-Tailored Solutions

See step-by-step solutions with expert insights and AI powered tools for academic success

Step: 2

blur-text-image_2

Step: 3

blur-text-image_3

Ace Your Homework with AI

Get the answers you need in no time with our AI-driven, step-by-step assistance

Get Started

Recommended Textbook for

Applied Statistics For Public And Nonprofit Administration

Authors: Kenneth J. Meier, Jeffrey L. Brudney, John Bohte

9th Edition

1285737237, 978-1285974521, 1285974522, 978-1285737232

More Books

Students explore these related Accounting questions