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Health plan premium. If a health plan covers 200,000 lives, expects 30 myocardial infarctions (Mls) to occur each year within the covered lives, expects a
Health plan premium. If a health plan covers 200,000 lives, expects 30 myocardial infarctions (Mls) to occur each year within the covered lives, expects a length of stay (LOS) of 4.5 days for each MI, and has to pay an average of $975 per day each day the MI patients is in the hospital, what is thePMPM cost to the health plan? What would have to be charged to the patient or employer if the health plan has administrative cost equaling 10 percent of its cost and it wants a profit margin of 7 percent?
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