Prepare a worksheet with each Payor and Patient Type and calculate the total annual revenues for Dr. Rossi.

IfDr.Rossiexpectsa5%shiftfromCommercialtoMedicaidInsurance,howwillhisrevenuesbeaffectedandbyhowmuch?Hint:ReducethenumberofCommercialpatientsfromHMOAby5%andaddthatnumbertotheMedicaidInsurancepatients.Makesureyoukeepthevisittopatientratiothesame.

Because of cost increases, Dr. Rossi needs to negotiate with HMO A Insurance for a higher rate.

• What should this rate be to cover an additional $5,000 in expenses with no shift in payor mix?
• Whatshouldthisratebetocoveranadditional$5,000inexpensesandtheshiftof5%fromCommercialtoMedicaid?

Giventheuncertaintyoftheshiftinpatienttypes,whatwouldyourecommendhisratetobe?DoyouthinktheinsurancewillacceptyourrateandWhy?

HSA 4150 HEALTHCARE FINANCIAL MANAGEMENT CASE DISCUSSION 1 - REVENUES DUE SEPTEMBER 12, 2016 OVERVIEW: John Rossi, MD is an Internal Medicine Physician. For the year 2015 he had the following Payor Mix: Below are the rates for his current contracts with Commercial Insurances and payment types, and the average rates per visit for Medicare and Medicaid: Dr. Rossi is concerned that there may be a shift in the payor mix towards a higher Medicaid population coming from the Commercial population. His contract with HMO A is coming for renewal soon. REQUIREMENTS: 1. Prepare a worksheet with each Payor and Patient Type and calculate the total annual revenues for Dr. Rossi. 2. If Dr. Rossi expects a 5% shift from Commercial to Medicaid Insurance, how will his revenues be affected and by how much? Hint: Reduce the number of Commercial patients from HMO A by 5% and add that number to the Medicaid Insurance patients. Make sure you keep the visit to patient ratio the same. 3. Because of cost increases, Dr. Rossi needs to negotiate with HMO A Insurance for a higher rate. a. What should this rate be to cover an additional $5,000 in expenses with no shift in payor mix? b. What should this rate be to cover an additional $5,000 in expenses and the shift of 5% from Commercial to Medicaid? 4. Given the uncertainty of the shift in patient types, what would you recommend his rate to be? Do you think the insurance will accept your rate and Why