FINANCIAL MANAGEMENT OF HEALTH SYSTEMS Assignment | Homework Help Websites
January 8th, 2019
HSA 6175 FINANCIAL MANAGEMENT OF HEALTH SYSTEMS
ASSIGNMENT1
Problem 1
OVERVIEW:
John Rossi, MD is an Internal Medicine Physician. For the year 2016 he had the following Payor Mix:
| Insurance | Patient Type | Contract Type | Contract Rate Per Visit* or PMPM** | Patients | Monthly Utilization | Visits |
| HMO A | Commercial | Fee for Service | $ 85.00 | 1,100 | 10% | 1,320 |
| HMOB | Medicare | Capitation | $ 45.00 | 500 | 31% | 1,860 |
| HMOB | Medicaid | Capitation | $ 15.00 | 350 | 9% | 378 |
| Medicare | Medicare | Fee for Service | $ 65.00 | 400 | 34% | 1,632 |
| Medicaid | Medicaid | Fee for Service | $ 35.00 | 435 | 11% | 574 |
| None | Self Pay | Fee for Service | $ 85.00 | 320 | 8% | 307 |
| Total | 3,105 | 6,071 |
* Average rate per visit
** Per member per month
REQUIRED:
- Using an Excel Worksheet, calculate Dr. Rossi’s revenues for 2016.
- HMO A has offered Dr. Rossi $11 PMPM capitation rate. Should he accept this offer? Why or why not?
Problem 2
OVERVIEW:
The Orthopedic Unit at Collins General Hospital had the following cases, excluding outliers:
REQUIRED:
- What is the average Per Diem paid by Medicare and the actual average Per Diem the hospital realized?
- State at least two reasons why the actual ALOS was higher than the average MS-DRG LOS?
Rubrics:
Submission of both problems 50%
Problem 1A 10%
Problem 1B 15%
Problem 2A 10%
Problem 2B 15%
