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The Citizen Hines HMO uses primary care provider (PCP) contracts that set the PCP capitation rate at $15 per member per month (PMPM). Citizen Hines
The Citizen Hines HMO uses primary care provider (PCP) contracts that set the PCP capitation rate at $15 per member per month (PMPM). Citizen Hines also contributes $45 PMPM to an institutional inpatient services risk pool and $30 PMPM to a specialist services risk pool. In addition, the contract includes a provision requiring a 20% withhold. Suppose that Citizen Hines budgeted $3,000,000 for inpatient services, and experienced $3,250,000 in actual inpatient services costs. If the inpatient services risk pool contained $300,000, and the provider contract specifies that the physicians (both PCPs and specialists) and the hospital share the risk pool equally (i.e., 50/50 split), how much did the physicians earn from the risk pool? $50,000 $25,000 $250,000 $0
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