Assessment Brief

Class: Financial Management of Healthcare Organizations
Text-book: Healthcare Finance: An Introduction to Accounting and
Financial Management
This weeks readings:
· 
Cost Behavior & Profit Analysis
· 
Cost Allocation
· 
Pricing & Service Decisions
· 
Planning & Budgeting
Analyzing Bay Pines Medical Center’s Financial Statement
After gaining an
understanding of the components of a financial statement, analyzing and
applying what the components represent, in terms of future planning, are the
most important aspects of working in healthcare finance. Consider the following
data and make your best analysis of per member per month (PMPM) rates,
considering reductions in utilization or pricing.
Bay Pines Medical Center
estimates that a capitated population of 50,000 would have the following base
case utilization and total cost characteristics:

Service Category

Inpatient Days
per 1,000 Enrollees

Average Cost
per Day

General

150

$1,500

Surgical

125

$1,800

Psychiatric

70

$700

Alcohol/Drug Abuse

38

$500

Maternity

42

$1,500

Total

425

$1,367

In addition to medical
costs, Bay Pines allocates 10 percent of the total premium for
administration/reserves.
Tasks:
On the basis of your
data analysis, respond to the following:
What is the PMPM rate that Bay Pines must set to cover
medical costs plus administrative expenses?What would be the rate if a utilization management
program were to reduce utilization within each patient service category by
10 percent? And by 20 percent?Consider the initial base case utilization assumption.
What rate would be set if the average cost on each service were reduced by
10 percent?Assume that both utilization and cost reductions were
made. What would the premium be?
Submission Details:
Present your analysis as a 3-page report in a Microsoft
Word document formatted in APA style.On a separate page, cite all sources using APA format.Name your document
SU_MHC6305_W3_A2_LastName_FirstInitial.doc.By Tuesday,
June 9, 2015, submit your assignment to the W3 Assignment 2
Dropbox.

Assignment 2 Grading Criteria

Maximum Points

Calculated the PMPM
rate to cover medical and administrative costs.

40

Calculated utilization
rates reduced by 10 percent.

36

Calculated utilization
rates reduced by 20 percent.

36

Calculated the rate
with the average service cost reduced by 10 percent.

40

Calculated the PMPM
premium after utilization and cost reductions.

40

Wrote in a clear,
concise, and organized manner; demonstrated ethical scholarship in accurate
representation and APA style attribution of sources; displayed accurate
spelling, grammar, and punctuation.

8

Total:

200

Additional Rubric
Criteria
Unsatisfactory
Emerging
Proficient
Exemplary
Score
Assignment Components:
Calculated the PMPM rate to cover medical and administrative
costs
0-14 Points
The calculation of the PMPM
rate is unclear and inaccurate.
15-24
Points
The calculation of the PMPM
rate is somewhat clear and accurate.
25-35
Points
The calculation of the PMPM
rate is clear and mostly accurate.
36-40
Points
The calculation of the PMPM
rate is clear and accurate and is supported by a peer reviewed reference.
__of 40
Calculated 10% reduced utilization rates
0-12
Points
The calculation of the PMPM
rate is unclear and inaccurate.
13-25
Points
The calculation of the PMPM
rate is somewhat clear and accurate.
26-32
Points
The calculation of the PMPM
rate is clear and mostly accurate.
33-36
Points
The calculation of the PMPM
rate is clear and accurate and is supported by a peer reviewed reference.
__of 36
Calculated 20% reduced utilization rates
0-12
Points
The calculation of the PMPM
rate is unclear and inaccurate.
13-25
Points
The calculation of the PMPM
rate is somewhat clear and accurate.
26-32
Points
The calculation of the PMPM
rate is clear and mostly accurate.
33-36
Points
The calculation of the PMPM
rate is clear and accurate and is supported by a peer reviewed reference.
__of 36
Calculated the rate with reduced average service cost by 10%.
0-14
Points
The calculation of the PMPM
rate is unclear and inaccurate.
15-24
Points
The calculation of the PMPM
rate is somewhat clear and accurate.
25-35
Points
The calculation of the PMPM
rate is clear and mostly accurate.
36-40
Points
The calculation of the PMPM
rate is clear and accurate and is supported by a peer reviewed reference.
__of 40
Calculated the PMPM premium after utilization and cost
reductions
0-14
Points
The calculation of the PMPM
rate is unclear and inaccurate.
15-24
Points
The calculation of the PMPM
rate is somewhat clear and accurate.
25-35
Points
The calculation of the PMPM
rate is clear and mostly accurate.
36-40
Points
The calculation of the PMPM
rate is clear and accurate and is supported by a peer reviewed reference.
__of 40
Presentation and
Writing Components:
Organization
Introduction
Transitions
Conclusion
0
Points
Introduction is limited or missing
entirely.
Transitions between ideas are
infrequent, illogical, or missing entirely.
Conclusion is limited or missing
entirely. 
0.5
Point
Introduction is present but
incomplete or underdeveloped.
Transitions between ideas are
sporadic.
Conclusion is recognizable, but
incomplete or underdeveloped.
1 Point
Introduction has an opening,
provides some background information, and states the topic.
Transitions between ideas are
present.
Conclusion
summarizes main argument and has a clear ending.
2
Points
Introduction catches the
audiences’ attention, provides compelling and appropriate background
information, and clearly states the topic.
Thoughtful transitions between
ideas are appropriate and help the flow of ideas.
Conclusion
leaves the audience with a sense of closure and provides concluding insights.
__of 2
Style
Tone
Audience
Word Choice
0
Points
Presentation (including background
images, text, choice of words, and appropriateness of tone) is lacking or
completely overpowers the presentation to the point of interfering with
comprehension, or design is inappropriate for the assignment.
0.5
Point
Presentation (such as background
images, text, choice of words, and appropriateness of tone) upstages the
writing, or design is too understated at points, or design is inconsistent.
1 Point
Presentation (such as background
images, text, choice of words, and appropriateness of tone) is clear,
appropriate for the assignment, balanced, and compliments the writing.
2
Points
Presentation (such as background
images, text, choice of words, and appropriateness of tone) is clear, appropriate for the
assignment, balanced, and compliments the writing throughout the
presentation. The design engages the audience and does not distract from
information.
__of 2
Usage and Mechanics
Grammar
Spelling
Sentence structure
0
Points
Any
written portion contains numerous errors in spelling, grammar, and/or has
sentence structure that severely interferes with readability and
comprehension.
0.5
Point
Any
written portion contains errors in spelling and grammar that somewhat
interfere with comprehension.
1 Point
Any
written portion follows conventions of spelling
and grammar throughout. Errors are infrequent and do not interfere with
comprehension.
2
Points
The
presentation is basically error free in terms of mechanics. In any written
portion, grammar and mechanics help establish a clear idea and aid the reader
in following the writer’s logic.
__of 2
APA Elements
Attribution
Paraphrasing
Quotations
When appropriate or assigned
0
Points
No attempt at APA formatting in presentation.
0.5
Point
APA format is attempted to
paraphrase, quote, and cite, but errors are significant.
1 Point
Used APA format, accurately
paraphrased, quoted, and cited in most areas throughout when appropriate or
called for. Errors present are mostly minor.
2
Points
Used APA format, accurately paraphrased, quoted, and cited throughout
when appropriate or called for. Only a few minor errors present.
__of 2
Comments 
Total
Score ___200