Student’s Name: Professor’s Name: Course Code; Date: Analysis 2000 cases in the proportions. 40% Commercial insurance 25% Medicare insurance 15% Medicaid insurance 15% Liability insurance 5% Others including self-pay. What are the proportions of the total cases for each payer? 2000x40/100= 800 Commercial insurance 2000x25/100= 500 Medicare insurance 2000x15/100= 300 Medicaid insurance 2000x15/100=300 Liability insurance 2000x5/100=100 Others including self-pay. What are the individual reimbursement rates for all 5 payers? $6200x110/100=6820 Commercial average $6200x65/100=4030 Medicaid average $6200x200/100=12400 Liability average $6200 x 100/100= 6200 Others including self-pay $6200x100/100= 6200 Medicare average What are the expected rates of reimbursement for this time frame for each payer? What is the expected A/R? $6820Commercial insurance $4030 Medicaid insurance $12400 Liability insurance $6200 Medicare insurance $6200 Others including self-pay. The expected A/R= 6820+4030+12400+6200+6200= $35 650 What rate should you charge for these services (assuming one charge rate for all payers)? (This gives you your total usages in business. First capital investment can be used to refer to money used by the business in purchase of fixed assets like land and machinery. Capital investment can also be used to refer to money invested in business with the idea that the cash will be used in purchasing fixed assets than covering the daily running of the business operating expenses. Capital budgeting is the planning process used in determining whether organization’s long-term investments are worth funding of the money through the firm’s capitalization structure. While capital structure involves how the firm finances its overall operations and growth by using different sources of funds. The company is objected to use the available resources to expand its business venture to other parts and also used the available resources to run its operations and also invest in long-term assets that could lead to its growth and expansion in the future. [...]
Your facility has the following payer mix: 40% commercial insurances 25% Medicare insurance 15% Medicaid insurance 15% liability insurance 5% all others including self-pay Write a 3-4 page report that addresses the following requirements: Assume that for the time in question you have 2000 cases in the proportions above. (What are the proportions of the total cases for each payer?) The average Medicare rate for each case is $6200- use this as the baseline. Commercial insurances average 110% of Medicare, Medicaid averages 65% of Medicare, Liability insurers average 200% of Medicare and the others average 100% of Medicare rates. (What are the individual reimbursement rates for all 5 payers?) What are the expected rates of reimbursement for this time frame for each payer? What is your expected A/R? What rate should you charge for these services (assuming one charge rate for all payers)? (This gives you your total A/R.) Calculate the total charges for all cases based on this rate. What is the difference between the two A/R rates above? Can you collect it from the patient? What happens to the difference? Which of these costs are fixed? Which are variable? Direct or indirect? materials/supplies (gowns, drapes, bedsheets) Wages (nurses, technicians) Utility, building, usage exp (lights, heat, technology) Medications Licensing of facility Per diem staff Insurances (malpractice, business etc.) Calculate the contribution margin for one case (in $) with the following costs for this period, per case: a. materials/supplies: $2270 b. Wages: $2000 c. Utility, building, usage exp: $1125 d. Insurances (malpractice, business etc.): $175 Using the above information, determine which is fixed and which cost is variable. Then calculate the breakeven volume of cases in units for this period. Suppose you want to make $150,000 profit between this period and next period to fund an expansion to the NICU, how many cases would you have to see? At what payer mix would this be optimal?