WK 8 Cost, Payment and Profit Analysis AH 531

1.Discuss the four above apropos of application the cost-to allegation allowance method. 2.What is the accord amid the concepts amount allocation base as acclimated in the step-down adjustment and amount disciplinarian as acclimated in ABC? 3.What is the aberration amid a amount object’s absolute amount and its absolutely allocated cost? Give an example. 4.What are the advantages and disadvantages of ABC about to the step-down adjustment of amount allocation? 5.Name the units of account on which cost-based payers may pay providers. 6.How do copayments and deductibles abate risk? 7.Why do providers admiration “steerage”? 8.Who bears the accident beneath a collapsed is system? Why? 9.How do HMOs uses actuate their premiums? 10.If an HMO covered 150,000 lives, accepted 25 myocardial infarctions (MI) to action anniversary year aural the covered lives, would apprehend a breadth of break of 4.5 canicule for anniversary MI, and had to pay an boilerplate of $950 per day for anniversary day the MI accommodating was in the hospital, what would the PMPM amount of the HMO be? What would accept to be answerable to the patient/employer if the HMO had authoritative costs equaling 10 percent of its costs and it capital a accumulation allowance of 7 percent?

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