Question: Please answer the question if your well familiar with Class: HSM 340, Essential of Health Care Finance. Two questions I need help with. 1. Based
Please answer the question if your well familiar with Class: HSM 340, Essential of Health Care Finance. Two questions I need help with.
1. Based on the below information, what dollar effect did the increased admission rate have on cost?
| You have been asked by management to explain the variances in costs under your inpatient capitated contract. The following data is provided. Use the following data to calculate the variances. | ||
|
| Budget | Actual |
| Inpatient Costs | $12,568,500 | $16,618,350 |
| Members | 42,000 | 42,000 |
| Admission Rate | 0.070 | 0.095 |
| Case Mix Index | 0.90 | 0.85 |
| Cost per Case (CMI = 1.0) | $4,750 | $4,900 |
2.Based on the information below, what rate must be set to generate the required $80,000 in profit in the preceding example?
You have been asked to establish a pricing structure for radiology on a per-procedure basis. Present budgetary data is presented below:
| Budgeted Procedures | $10,000 |
| Budgeted Cost | $400,000 |
| Desired Profit | $80,000 |
It is estimated that Medicare patients comprise 40 percent of total radiology volume and will pay on average $38.00 per procedure. Approximately 10 percent of the patients are cost payers. The remaining charge payers are summarized below:
| Payer | Volume% | Discount% |
| Blue Cross | 20 | 4 |
| Unity PPO | 15 | 10 |
| Kaiser | 10 | 10 |
| Self-Pay | 5 | 40 |
|
| 50% |
|
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