VIP-MD is a health maintenance organization (HMO) located in North Carolina. Unlike the traditional fee-for-service model that

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VIP-MD is a health maintenance organization (HMO) located in North Carolina. Unlike the traditional fee-for-service model that determines the payment according to the actual services used or costs incurred, VIP-MD receives a fixed, prepaid amount from subscribers. The per member per month (PMPM) rate is determined by estimating the health care cost per enrollee within a geographic location. The average health care coverage in North Carolina costs $368 per month, which is the same amount irrespective of the subscriber's age. Because individuals are demanding quality care at reasonable rates, VIP-MD must contain its costs to remain competitive. A major competitor, National Physicians, is entering the North Carolina market in early 2016 with a monthly premium of $325. VIP-MD wants to maintain its current market penetration and hopes to increase its enrollees in 2016. The latest data on the number of enrollees and the associated costs follow:

VIP-MD is a health maintenance organization (HMO) located in North

Required
1. Calculate the target cost required for VIP-MD to maintain its current market share and profit per enrollee in 2016.
2. Costs in the health care industry applicable to VIP-MD and National Physicians are expected to increase by 7% in the coming year, 2017. VIP-MD is planning for the year ahead and is expecting all providers, including VIP-MD and National Physicians, to increase their rates by $25 to $350. Calculate the new target cost assuming again that VIP-MD wants to maintain the same profit per enrollee as in 2016?

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Related Book For  book-img-for-question

Cost Management A Strategic Emphasis

ISBN: 978-0077733773

7th edition

Authors: Edward Blocher, David Stout, Paul Juras, Gary Cokins

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