Families First is a managed care plan that has been asked to submit a premium bi
ID: 2668599 • Letter: F
Question
Families First is a managed care plan that has been asked to submit a premium bid to ABC Company, a largemanufacturer in its service area. The premium bid includes the primary care for all of the ABC employees.
ABC has provided information about the age and gender of its employees, and Families First has identified
average primary care utilization rates from its own databases. This information is shown below:
ABC Company Average primary care
Number of Number of visits per year
Age Band males females Males Females
20-29 285 325 2.10 3.18
30-39 96 100 2.60 3.52
40-49 53 57 3.28 3.93
50-59 36 36 4.14 4.43
60+ 7 5 4.98 5.04
Each primary care physician can handle about 3,000 patient visits per year, for which he or she is paid
$180,000. What primary care rate (PMPM) will Families First propose to ABC Company?
Explanation / Answer
20-29
There are 285 and they to 2.1 times/year each
= 285 * 2.1 = 598.5 visits
There are 325 and they go 3.18 times/year
= 1033.5 visits
-----------------------------------------------------
30- 39
Males 96 at 2.6 times/year = 249.6 visits
Females 100 at 3.2 times/year = 320 visits
------------------------------------------------------
40-49
Males 53 times 3.28 =174.8
Females 57 times 3.93 = 224.01
-------------------------------------------------------
50-59
Males 36 times 4.14 = 149.04
Females 36 times 4.43 = 159.48
--------------------------------------------------------
60-69
Males 7 times 4.98 = 34.86
Females 5 times 5.04 = 25.2
-------------------------------------------------------
The total visits = 2968.03
= 2968.03 * $180,000
= $ 178,021
Related Questions
Navigate
Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.