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(TCO 3) From a hospital's perspective, what is most likely to be the highest risk arrangement with a payer?

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    1. (TCO 3) From a hospital's perspective, what is most likely to be the highest risk arrangement with a payer?
    2. (TCO 3) SKF Primary Care Clinic is deciding whether to purchase MRI equipment that would enable it to perform MRI imaging services in-house rather than sending its patients to its competitor's hospital three miles away. From a financial position, if SKF were to make its decision without using net present value analysis, the clinic would need to know (or at least reasonably estimate) which of the following information?
    3. (TCO 3) Your controller has told you that the marginal profit of DRG 209 (major joint procedure) for a Medicare patient exceeds the marginal profit for an average charge patient. Why might this occur?
    4. (TCO 3) Which of the following is the first step in any budgetary process?
  • (TCO 3) David Jones, the new administrator for a surgical clinic, was trying to determine how to allocate his indirect expenses. His staff was complaining that the current method of taking a percentage of revenues was unfair. He decided to try to allocate utilities based on square footage of each department, administration based on direct costs, and laboratory based on tests. Use the information in the chart below to answer the question.
  •  
  • Square Footage
  • Direct Expenses
  • Lab Tests
  • Utilities
  •  
  • 200,000
  •  
  • Administration
  • 2,000
  • 500,000
  •  
  • Laboratory
  • 2,000
  • 625,000
  •  
  • Day-op Suite
  • 3,000
  • 1,400,000
  • 4,000
  • Cystoscopy
  • 1,500
  • 350,000
  • 500
  • Endoscopy
  • 1,500
  • 300,000
  • 500
  • Total
  • 10,000
  • 3,625,000
  • 5,000

  • Based on the scenario above, what are the Endoscopy Department's total expenses?
  • (TCO 3) Your hospital has been approached by a major HMO to perform all their MS-DRG 470 cases (major joint procedures). They have offered a flat price of $10,000 per case. You have reviewed your charges for MS-DRG 470 during the last year and found the following profile:
  • Average Charge
  • $15,000
  •  
  • Average LOS
  • 5 Days
  •  
  • Routine Charge
  • $3,600
  • Cost/Charge 0.80
  • Variable Cost % 60
  • Operating Room
  • 2,657
  • 0.80
  • 80
  • Anesthesiology
  • 293
  • 0.80
  • 80
  • Lab
  • 1,035
  • 0.70
  • 30
  • Radiology
  • 345
  • 0.75
  • 50
  • Medical Supplies
  • 4,524
  • 0.50
  • 90
  • Pharmacy
  • 1,230
  • 0.50
  • 90
  • Other Ancillary
  • 1,316
  • 0.80
  • 60
  • Total Ancillary
  • $11,400
  • 0.75
  • 50

  • The HMO in the above example has indicated that their doctors use less expensive joint implants. If this less expensive implant were used, your medical supply charges would be reduced by $2,000. What is the estimated reduction in variable cost?
  1. (TCO 3) What is the break-even equation and discuss the break-even equation?

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