Service Category<\/p>\n<\/td>\n

Inpatient Days
per 1,000 Enrollees<\/p>\n<\/td>\n

Average Cost
per Day<\/p>\n<\/td>\n<\/tr>\n

General<\/p>\n<\/td>\n

150<\/p>\n<\/td>\n

$1,500<\/p>\n<\/td>\n<\/tr>\n

Surgical<\/p>\n<\/td>\n

125<\/p>\n<\/td>\n

$1,800<\/p>\n<\/td>\n<\/tr>\n

Psychiatric<\/p>\n<\/td>\n

70<\/p>\n<\/td>\n

$700<\/p>\n<\/td>\n<\/tr>\n

Alcohol\/Drug Abuse<\/p>\n<\/td>\n

38<\/p>\n<\/td>\n

$500<\/p>\n<\/td>\n<\/tr>\n

Maternity<\/p>\n<\/td>\n

42<\/p>\n<\/td>\n

$1,500<\/p>\n<\/td>\n<\/tr>\n

Total<\/p>\n<\/td>\n

425<\/p>\n<\/td>\n

$1,367<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

In addition to medical costs, Bay Pines allocates 10 percent of the total premium for administration\/reserves.<\/p>\n

On the basis of your data analysis, respond to the following:<\/p>\n

\n
• What is the PMPM rate that Bay Pines must set to cover medical costs plus administrative expenses?<\/li>\n
• What would be the rate if a utilization management program were to reduce utilization within each patient service category by 10 percent? And by 20 percent?<\/li>\n
• Consider the initial base case utilization assumption. What rate would be set if the average cost on each service were reduced by 10 percent?<\/li>\n
• Assume that both utilization and cost reductions were made. What would the premium be?<\/li>\n
• The paper must be 8 to 10 pages in length and be in APA 7th edition format<\/li>\n<\/ul>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

  Consider the following data and make your best analysis of per member per month (PMPM) rates, considering reductions in utilization or pricing. Bay Pines Medical Center estimates that a capitated population of 50,000 would have the following base-case utilization and total cost characteristics: Service Category Inpatient Daysper 1,000 Enrollees Average Costper Day General 150 $1,500 […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_joinchat":[]},"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/qualityassignments.net\/wp-json\/wp\/v2\/posts\/175363"}],"collection":[{"href":"https:\/\/qualityassignments.net\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/qualityassignments.net\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/qualityassignments.net\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/qualityassignments.net\/wp-json\/wp\/v2\/comments?post=175363"}],"version-history":[{"count":0,"href":"https:\/\/qualityassignments.net\/wp-json\/wp\/v2\/posts\/175363\/revisions"}],"wp:attachment":[{"href":"https:\/\/qualityassignments.net\/wp-json\/wp\/v2\/media?parent=175363"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/qualityassignments.net\/wp-json\/wp\/v2\/categories?post=175363"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/qualityassignments.net\/wp-json\/wp\/v2\/tags?post=175363"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}