Assumption for Part 1
Table A: Assumptions for Net PMPM Capitation Payments
HMO Product	Copay/Visit	% Withhold	Average # of Members/Month
Diamond Select Premium Plus	$20.00	20%	16
Select Choice Plus	$30.00	20%	27
Premium Omega ValueNet	$40.00	20%	57
Table B: Assumptions for the Year-End PCP Withhold Distribution
Percent of Aggregate Withhold, Meaning the Total of All Withholds for All PCPs, Used by the HMO for Cost Overruns.	14%
Percent of Network PCP's Eligible to Receive a Withhold Distribution of any remaining dollars in the withhold pool.	82%
Table C: Assumptions for PCP FFS Revenue per Visit
Average total FFS revenue per visit:	$120.00
Average number of visits per member per year:	4.2

use this data to answer

1: Net PMPM and Dollar Capitation Payment Rates for Each Product
Starting with the base capitation rate that you calculated above, calculate the net PMPM payment rates after any deductions, and total dollars of payment per month under capitation for each product; and the total dollar amount per month for all products combined.
HMO Product	$ PMPM	Dollars per Month
Net Cash HMO Pmt.	Amt. Withheld	Net HMO Cash Pmt.	Amt. Withheld
Diamond Select Premium Plus			$	$
Select Choice Plus			$	$
Premium Omega ValueNet			$	$
Total for All Products, (Dollars):	$	$
2: Dollars Collected by PCP Each Year from Copays for Each Product
Calculate how much, in dollars per year, a PCP collects in copays from HMO members, for each product, and in total.
HMO Product	Dollars/Year in Collected Copays
Diamond Select Premium Plus	$
Select Choice Plus	$
Premium Omega ValueNet	$
Total for All HMO Products (Dollars):	$
3: Aggregate Dollars in Withhold, Used for Cost Overruns, Available for Distribution for PCP Distribution, and Amount Distributed to Dr. Welby.
Calculate the year-end total dollar amount of withhold money in the aggregate risk pool, the amount used for cost overruns, the amount remaining for distribution to eligible PCPs, and the amount distributed to Dr. Welby.
	Amount in Dollars
Total Amount the Aggregate PCP Withhold Risk Pool:	$
Total Amount of the Aggregate Withhold Used for Cost Overruns:	$
Total Aggregate Amount Remaining for Distribution to All Eligible PCPs:	$
Amount of Withhold Distribution to Dr. Welby:	$
4: Put It All Together and Compare it to FFS
Calculate the total dollar amount paid to Dr. Welby at the end of the year, including total net capitation payments plus Dr. Welby's withhold distribution amount; and compare Dr. Welby's annual revenue under this example of capitation to Dr. Welby's annual FFS revenue.
For Dr. Welby Only, in Dollars
Total Annual Net HMO Capitation Payment:	$
Total Annual Amount of Collected Copayments:	$
Year-End HMO Withhold Distribution to PCP:	$
Total Annual Revenue Under This Capitation Method:	$
5: Capitation Compared to FFS Revenue
Starting with the average FFS revenue per visit assumptions, calculate the equivalent base capitation rate, the average FFS revenue per patient per year, and the average total FFS revenue per 100 patients per year.
Base Equivalent PMPM Capitation Payment Rate:	$
Total FFS Revenue per Patient per Year (Dollars):	$
Total FFS Revenue per 100 Patients per Year (Dollars):	$
Amount Over or Under Compared to FFS Revenue	$