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The Medicine Department at My Mountain Medical Clinic provides 2 types of services: Basic Office Visits and Complex Patient Office Visits. Below is some information on the Utilization of Medicine Department Services. Costs: Annual Fixed Costs for the Medicine Department are $607,500. The Variable Cost for a basic Visit is $50 Variable Cost for a Complex visit is $95. Service Annual % Medicare % Capitated % Uncompensated Visits % Commercial Fee for Service 4000 25% 57% 15% 3% Basic Visit 1500 36% 40% 22% 2% Complex Visits Medicare pays $80 for a basic visit and $300 for a complex visit. Currently My Mountain Clinic has 1 capitated contract with an HMO that has 20,000 enrollees. That contract currently pays a PMPM of $1.50. Medicare pays $80 for a basic visit and $300 for a complex visit. Currently My Mountain Clinic has 1 capitated contract with an HMO that has 20,000 enrollees. That contract currently pays a PMPM of $1.50. Given the Medicare and Capitated payment amounts, If your current commercial fee for service contract pays $85 for a basic visit, what do you need to charge the Fee for Service commercial payers for a complex visit to break even? a $180 b $257 0 $95 d. None of these e $300 at My Mountain Medical Clinic provides 2 types of services: Basic Office Visits and Complex Patient Office Visits. Below is some information on the Utilization of Medicine Department Services, Costs: Annual Fixed Costs for the Medicine Department are $607,500. The Variable Cost for a basic Visit is $50 Variable Cost for a Complex visit is $95. Service Annual % Medicare % Commercial Fee for Service % Uncompensated Visits Capitated 4000 25% Basic Visit 57% 15% 39 1500 36% Complex Visits 40% 2298 29 Medicare pays $80 for a basic visit and $300 for a complex visit Currently My Mountain Clinic has 1 capitated contract with an HMO that has 20,000 enrollees. That contract currently pays a PMPM of $1.50, Medicare pays $80 for a basic visit and $300 for a complex visit. Currently My Mountain Clinic has 1 capitated contract with an HMO that has 20,000 enrollees. That contract currently pays a PMPM of $1.50. You are now renegotiating the rate for basic visits with your fee for service commercial contracts. You have decided that you need to make $25,000 per year profit. Given the given Medicare and Capitated payment amounts, and the price you calculated for complex commercial fee for service rate to break even, What price do you need to charge commercial payers for a basic visit to make a $25,000 per year profit? a $95.96 b. $54.70 c None of these d$88.00 e. $92.50 Big Dental HMO has 100,000 enrollees. Looking at their historical records, Beg Dental HMO concludes that their members use 35 dental cleaning services per 100 members. How many Dental Cleanings are performed on Big Dental HMO members? a. 35 b. 3500 c. 35,000 d. 100,000 Under capitated payment systems, PMPM impacts revenue and Utilization rate impacts costs. The number of members impacts both revenue and costs. Select one: True False