Assume that Valley Forge Hospital has only the following three payer groups:

Payer Number of Average Revenue Variable Cost

Admissions per Admission Per Admission

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Penn Care 1,000 $5,000 $3,000

Medicare 4,000 4,500 4,000

Commercial 8,000 7,000 2,500

The hospitals fixed costs are $38 million

What is the hospitals net income?

Assume that half of the 100,000 covered lives in the commercial payer group will be moved into the capitated plan. All utilization cost data remain the same. What PMPM rate will the hospital have to charge to retain its part A net income.

What overall net income would be produced if the admission rate of the capitated group were reduced by 10 percent?

Assuming that the utilization reduction also occurs, what overall net income would be produced if the variable cost per admission for the capitated group were lowered to $2,200?