Nursing home can experience before it begins to lose money

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Reference no: EM131989877

1. A nursing home contracts with an HMO for skilled nursing care at $2.50 PMPM. If costs are expected to average $150 per day, what is the maximum utilization of days per 1,000 members that the nursing home can experience before it begins to lose money?

2. An HMO has a Point of Service (POS) option for its members, but will pay only 80 percent of approved charges. If a member goes out of network for a medical procedure with a charge of $3,000, of which $2,000 is approved, how much must the member pay?

Reference no: EM131989877

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