VIP-MD is a health maintenance organization (HMO) located in North Carolina. Unlike the traditional fee-for-service model that determines the payment according to the actual services used or costs incurred, VIP-MD receives a fixed, prepaid amount from subscribers. The per member, per month rate (PMPM) is determined by estimating the health care cost per enrollee within a geographic location. The average health care coverage in North Carolina costs $361 per month, which is the same amount irrespective of the subscriber’s age. Because individuals are demanding quality care at reasonable rates, VIP-MD must contain its costs to remain competitive. A major competitor, National Physicians, entered the North Carolina market early in the current year with a monthly premium of $318. VIP-MD wants to maintain its current market penetration and hopes to increase its enrollees in the current year. The latest data on the number of enrollees and the associated costs follow:
Age | Enrollment in Current Year | Projected Enrollment Next Year | Average Monthly Cost in Current Year | |||||||||
1–4 | 44,988 | 48,277 | $ | 11,147,172 | ||||||||
5–14 | 81,756 | 83,963 | 10,058,932 | |||||||||
15–19 | 95,173 | 95,187 | 8,436,124 | |||||||||
20–24 | 65,546 | 67,182 | 9,538,724 | |||||||||
25–34 | 132,796 | 131,854 | 26,431,508 | |||||||||
35–44 | 166,176 | 174,746 | 38,881,408 | |||||||||
45–54 | 84,796 | 90,189 | 22,741,236 | |||||||||
55–64 | 98,524 | 101,223 | 28,691,012 | |||||||||
65–74 | 155,588 | 160,859 | 49,517,444 | |||||||||
75–84 | 67,195 | 71,765 | 33,432,060 | |||||||||
85 years and older | 22,799 | 26,149 | 24,285,775 | |||||||||
1,015,337 | 1,051,394 | $ | 263,161,395 | |||||||||
Required:
1. Calculate the target cost required for VIP-MD to maintain its current market share and profit per enrollee in the current year.
ANSWER
Current total costs | $263,161,395 |
Total enrolls | 1,015,337 |
Cost per enroll | $259.19 |
Current Price | $ 361 .00 |
Profit | $101.81 |
New Price | $318.00 |
Required Profit | $101.81 |
Target cost | $216.19 |
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VIP-MD is a health maintenance organization (HMO) located in North Carolina. Unlike the traditional fee-for-service model...
VIP-MD is a health maintenance organization (HMO) located in North Carolina. Unlike the traditional fee-for-service model that determines the payment according to the actual services used or costs incurred, VIP-MD receives a fixed, prepaid amount from subscribers. The per member, per month rate (PMPM) is determined by estimating the health care cost per enrollee within a geographic location. The average health care coverage in North Carolina costs $361 per month, which is the same amount irrespective of the subscriber’s age....
VIP-MD is a health maintenance organization (HMO) located in North Carolina. Unlike the traditional fee-for-service model that determines the payment according to the actual services used or costs incurred, VIP-MD receives a fixed, prepaid amount from subscribers. The per member, per month rate (PMPM) is determined by estimating the health care cost per enrollee within a geographic location. The average health care coverage in North Carolina costs $362 per month, which is the same amount irrespective of the subscriber’s age....
13-7.VIP-MD is a health maintenance organization (HMO) located in North Carolina. Unlike the traditional fee-for-service model that determines the payment according to the actual services used or costs incurred, VIP-MD receives a fixed, prepaid amount from subscribers. The per member, per month rate (PMPM) is determined by estimating the health care cost per enrollee within a geographic location. The average health care coverage in North Carolina costs $371 per month, which is the same amount irrespective of the subscriber’s age....
13-7. VIP-MD is a health maintenance organization (HMO) located in North Carolina. Unlike the traditional fee-for-service model that determines the payment according to the actual services used or costs incurred, VIP-MD receives a fixed, prepaid amount from subscribers. The per member, per month rate (PMPM) is determined by estimating the health care cost per enrollee within a geographic location. The average health care coverage in North Carolina costs $371 per month, which is the same amount irrespective of the subscriber’s...
required intormauon The following information applies to the questions displayed below.) VIP-MD is a health maintenance organization (HMO) located in North Carolina. Unlike the traditional fee for service model that determines the payment according to the actual services used or costs incurred, VIP-MD receives a fixed, prepaid amount from subscribers. The per member, per month rate (PMPM) is determined by estimating the health care cost per enrollee within a geographic location. The average health care coverage in North Carolina costs...
1.Calculate the targest cost required for VIP-MD to
maintain its current market share and profit per enrollee in the
current year.
2. Calculate the new target cost assuming again that the VIP-MD
wants to maintain the same profit per enrollee as in the current
year.
VIP-MD is a health maintenance organization (HM0) located in North Carolina. Unlike the traditional fee-for-service model that determines the payment according to the actual services used or costs incurred, VIP-MD receives a fixed, prepaid amount...
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