Finance-AW76

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Healthcare Financial Management and Economics
 
Supply of Primary Care Workforce
 

Scenario: Your hospital has an opportunity to participate with an Accountable Care Organization (ACO) contract with 20,000 ACO patients. The ACO patient population expects about 2,000 avoidable hospitalizations per year with a potential savings of $20 million, which will be shared as follows: 50% revenue to the insurer and 50% revenue to the hospital. The ACO patient population will require an average of six office visits per year, and 120,000 total office visits will need to be supplied by your primary care workforce.
 
To prepare for this Assignment
 

Based on the scenario and financial data provided by the course Instructor, conduct a financial projection (revenues, expenses, and profit) that analyzes the efficiency of the supply of health services.
 
The Assignment
 

In a 2- to 3-page Word document that includes tables and/or calculations, make recommendations on the following: 1) number of physicians and nurse practitioners needed; 2) reimbursement method: salary or fee-for-service; 3) recommendations for financial incentives to address the challenges of supplier-induced demand and how to ensure efficiency. Interpret the net profit from the ACO contract based on your recommendations. Explain the rationale behind your recommendations, including the impact made by your financial calculations.
 

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Financial Data
 

ACO revenue
Number of ACO patients 20,000
 
Potential savings
 

Number of avoidable hospitalizations per patient 0.1
Total avoidable hospitalizations per year 2,000
Cost per avoidable hospitalization $10,000
Total cost of avoidable hospitalizations $20,000,000
 
Demand for healthcare/utilization
Number of office visits per patient 6
Total office visits per year 120,000
 
Supply of workforce/expense
Employed providers (salary)
Physician salary per year $200,000
Nurse practitioner salary per year $100,000
Contracted providers (fee-for-service)
Physician fee per visit $100
Nurse practitioner fee per visit $50
&nbsp
Productivity
 

Physician visits per year 3,000
Nurse practitioner visits per year 2,000
 
Financial incentives
 

Salary bonus to ensure efficiency 10%
Bonus fee per visit to ensure efficiency $1
 
Product code: Finance-AW76

 
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