Families First is a managed care plan that has been asked to submit a premium bi
ID: 2815559 • Letter: F
Question
Families First is a managed care plan that has been asked to submit a premium bid to ABC Company,
a large manufacturer 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
paid $180,000. What primary care rate (PMPM) will Families First propose to ABC Company?
Families First is a managed care plan that has been asked to submit a premium bid to ABC Company,
a large manufacturer 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
paid $180,000. What primary care rate (PMPM) will Families First propose to ABC Company?
Explanation / Answer
No of Male emp No of Female emp Avg primary care visits (Males) Avg primary care visits (Females) Total Expected Primary care Male Total Expected Primary care Female Total Expected Primary care visit (No of Male * Avg Primary care visit male) (No of Female * Avg Primary care visit Female) Age Band 20-29 285 325 2.1 3.18 598.5 1033.5 1632 30-39 96 100 2.6 3.52 249.6 352 601.6 40-49 53 57 3.28 3.93 173.84 224.01 397.85 50-59 36 36 4.14 4.43 149.04 159.48 308.52 60+ 7 5 4.98 5.04 34.86 25.2 60.06 Total 3000.03 Thus amount to be paid (Considering $ 180000 FOR 3000 Visits - Ans $180000
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