Suppose USG decides to submit a premium bid to MSI of $40 PMPM for both primary and specialty physicians. The primary care physicians will be paid $13 PMPM; the specialty physicians will be paid on a discounted fee-for-service basis. To create proper incentives, USG establishes a professional services risk pool equal to 15 percent of the budget for specialist physicians. After reconciliation at the end of the year, any funds left in the risk pool are evenly split among all primary care physicians. 

If the actual payments to the specialist physicians total $720,000 during the year, what would a primary care physician's actual PMPM be after reconciliation at the end of the year?

Answer rating: 100% (QA)

To calculate the primary care physicians actual PMPM after reconciliation at the end of the year we ... View the full answer