A hospital has contracted with an HMO to provide acute care inpatient services f

Question

A hospital has contracted with an HMO to provide acute care inpatient services for $1,000 per day, subject to a 10 percent withhold. The proposed budget for inpatient services is based upon expected utilization of 600 days per 1,000 members at $1,000 per day, or $600,000 per 1,000 members. The hospital risk pool will be split equally between the hospital and a primary care physician group. If only 450 days per 1,000 members were utilized in the first year, how much would the hospital be paid per 1,000 members? A. 405,000 B. 502,500 C. 306,000 D. 500,000

Explanation / Answer

ANSWER:   B. 502500 The hospital risk pool will be split equally between the hospital and a primary care physician group. So the total payment to the hospital for Hospital 600000/2= 300000 Primary care physician group(actual utilisation days) 300000/600*450*90%= 202500 Total 502500

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