t's managed care agreement with the cost analysis, tell me the full cost gain/loss and the differential cost gain/loss for two scenarios: keeping the agreement and killing the agreement (use FY 2020's financials). In the event that the city will negotiate a rate increase, what percent increase do I need to ask for to cover our full costs and what percent increase do I need to ask for to cover our differential costs? What is your recommendation? [See chapter 8.] 7. As of the end of 2020, 38 states had expanded Medicaid based on the recommendations and incentives in the Affordable Care Act and 12 states had not expanded Medicaid, among them our state of Texas. From the hospital and physician perspectives, what are the advantages and disadvantages of expansion? From the state's perspective, what are the advantages and what are the disadvantages of expansion? [See chapter 7.] 8. Our radiology department is in violation of the antitrust statutes by developing a fee schedule using College of American Radiology relative value units (RVUs). You must establish a new RVU system before we can set FY 2021 rates. The radiology manager has already completed some of the work and I'll send it over to you [see Table IV at the end of this case study]. Please develop a hospital-specific RVU schedule and assign 2021 radiology oniran department rates. (Total radiology expenses for 2021, including hospital indirect costs, which must be covered by the department, are projected to be $20 million.) [See chapters 8 and 9.] EETING WITH MR. CHIEF e CEO Mr. Chief states: think we are losing money because of the COVID-19 pandemic and low investment eturns (investment income is 2 percent of long-term investments). Once everyone is accinated, I think business will be back to normal. Everyone seems happy-everyone xcept Ms. Fi Nance, whom you'll be replacing. She started last January and seemed creasingly frustrated with the way we do things here-she just didn't fit most of her recommendations, especially the recCase Study: Chisos Mount 474 Positi complay ONhi Adm TABLE III-D CMMC Average Charges per Day, Fiscal Year 2020 Media $10,000 Diet Medical/Surgical 14,000 HOUS ICU 12,000 plan OB/GYN 1,300 Nurs Swing beds 800 Skilled nursing facility 400 Lab Emergency department Imai Note: ICU: intensive care unit; OB/GYN: obstetrics/gynecology. Res phy TABLE IV phi CMMC Radiology Department Procedures Tech Supply 2020 No Minutes Volumes Procedure (% charge-based) 2020 Rate Expense do Radiology Chest 2-view (25%) 250 14 20 20,000 Chest 4-view (25%) 500 28 40 20,000 Hand (25%) 120 5 10 7,000 Arm (25%) 240 10 20 4,000 Foot ( 25% ) 120 5 10 1,000 Leg (25%) 240 10 20 Fluoroscopy (50%) 6,000 700 30 60 Ultrasound OSOS 189Y 4,000 Abdomen (75%) 280 Other (75%) 15 20 05,000 250 Nuclear Medicine 10 20 5,622 Scan (50%) 820 Computed Tomography (CT) 60 60 2,000 Head without contrast (75%) Head with contrast (75%) 1,100 30 100 Body without contrast (50%) 1,500 60 200 Body with contrast (50%) 1,400 150 30 300 1,800 150 60 400 200 500