Question Description
Health Care Services Reimbursement
Case Assignment
Pearland Medical Center owns a small satellite clinic, specializingin General Practice, located at nearby Pearland airport. GeneralPractice Clinic’s sole payor is Air Health, a health care plan thatcovers the airport employee population. Air Health has been paying on afee-for-service basis; however, recently, its covered populationincreased and it proposed a capitation contract for the next year withan annual capitation payment of $150 for each of its 20,000 coveredmembers.
Previous experience indicates that the covered population willaverage 2 visits per year to General Practice Clinic. General PracticeClinic generates annually $1,150,000 fixed cost, which includes $550,000in direct cost
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