Question
Please answer B. only thank you Suppose Cigna, a PPO payer, is responsible for revenues of $8,000,000 per year. The Cigna contract is up for
Please answer B. only thank you
Suppose Cigna, a PPO payer, is responsible for revenues of $8,000,000 per year. The Cigna contract is up for renegotiation in July of 2022, and St. Elizabeth desires a 3% increase to net revenue.
Assuming all else remains constant and Cigna rate increases produce the 3% increase it penciled into the rate schedule, how much revenue will Cigna provide the system annually if it achieves its 3% increase goal? 8,240,000 3% is the increase to net revenue 3% of 8,000,000 is 240,000 8,000,000 + 240,000 = 8,240,000
b. At the negotiating table, Cigna explains that the way it can grant such an increase for the coming year (effective July of 2023) is through its quality program. There are three metrics that will be analyzed in July of 2023 for the preceding 365-day period: readmission rates, hospital-acquired infections, and patient satisfaction. If a retrospective look right before the July of 2023 effective date shows that St. Elizabeth has achieved the target for readmission rates and patient satisfaction but not for hospital-acquired infection: a. Assuming all measures are weighted equally, what is the percentage increase to rates for July of 2023?
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