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A hospital has contracted with and HMO to provide acute care impatient services for $1000 per day, subject to a 10% withhold. The proposed budget for inpatient services is based upon expected utilization of 600 days per 1,00 members at $1000 per day, or $600,000 per 1,000 members. The hospital risk pool will be split equally between the hospital and a primary care physician group. If only 450 days per 1000 members were utilized in the first year, how much would the hospital be paid per 1000 members?
what causes a shift in the balance of payment?
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