For this assignment you will be tackling the operational characteristics of health care insurance and managed care. Critically think through each set of questions and provide your answers below.

$1.$ How can a patient benefit if the premiums paid are more than the cost of the medical care received? How can an insurance company benefit if the medical care it provides costs more than the premiums paid in$?$

$2.$ What are four main ways HMOs act to reduce the cost of care?

$3.$ Which organization provides the largest amount of payment to physicians in the United States $($FYI: it is a Government organization$)?$ How does this organization choose to make these payments? Has the form of payment changed over time? Why?

$4.$ How are the values determined in setting up a relative value scale?

$5.$ A company with $617$ employees had the following expenses this year $(2018)$:

Cost $($each$)$

$14$ hospitalizations $$5,600$

$37$ physical therapy sessions $$340$

$9$ births $$1,800$

$4\mathrm{.}1$ physician visits per employee $$55$

$2\mathrm{.}4$ prescriptions filled per employee $$21$

Populate your answers within the columns below:

Expenditure in $2018$ Cost each $ Total cost $

$14$ hospitalizations

$37$ physical therapy

$9$ births

$4\mathrm{.}1$ physician visits per employee

$2\mathrm{.}4$ prescriptions filled per employee

Total expenditures in $2018$

$

Assuming that the cost of medical care rises $7$ percent over the next year, what would the actuarially fair premium be for the next year $(2019)?$

Total expected expenditure in $2019$

$

Actuarially fair premium per employee

$