What actions would you take at the mid-year point if you were a capitated hospital?

The subsequent two spreadsheets provide workload (expressed as relative weighted products (RWPs) for inpatient care), revenue, and expense data for Schumpert Medical Center covering their fiscal years 2010 and 2011. The data includes FY10 actual workload, revenues, and expenses; FY11 forecasted workload, revenues, and expenses; and FY11 year-to-date workload, revenues, and expenses. The Inpatient Product Lines worksheet provides further details on the types of services provided within each major service line. Using the available data, perform a variance analysis on Schumpert Medical Center and answer the following questions:
1. What was the hospital’s original profit forecast (assume away any issues with depreciation, taxes, etc.)? Halfway through the fiscal year, what is the hospital’s revised projection for FY11 profits?
Answer:
2. Which inpatient service lines are overbudget? Which product lines are overbudget after accounting for workload increases?
Answer:
3. What actions would you take at the mid-year point if you were a fee-for-service hospital? In other words, where are the problem areas on which you would focus your attention, and who might provide ideas for “best practices” based on their performance?
Answer:
4. What actions would you take at the mid-year point if you were a capitated hospital? In this case, the revenue spreadsheet would be replaced with an overall budget of $50 million with which to operate (rather than being able to bill for each episode of patient care). Federal, state, county, and city hospitals normally operate under a capped budget. Additionally, many HMOs also operate under a fixed Per Member, Per Month (PMPM) capitated process.
Answer:

 

Revenues Worksheet, Mid-Year Review
Inpatient
Inpatient Product Line Price/RWP Forecasted RWPs
For FY11
Projected IP Revenue
For FY11
Actual RWPs
(FY11 YTD)
Actual IP Revenue
(FY11 YTD)
CIRC $     6,010.65 724 $                 4,351,711 421 $               2,530,676
DIGEST $     6,021.65 1,161 $                 6,988,125 636 $               3,830,402
ENT $     6,001.65 130 $                   780,215 72 $                 433,948
GYN $     6,013.65 219 $                 1,313,983 116 $                 697,128
MENTAL HEALTH $         502.99 1,351 $                   679,539 736 $                 369,949
NERVOUS $     6,103.65 228 $                 1,391,632 112 $                 682,744
NEWBORN $     7,014.71 733 $                 5,141,782 433 $               3,033,900
OB $     5,713.65 1,501 $                 8,576,189 868 $               4,960,622
ORTHO $     6,084.18 631 $                 3,839,118 274 $               1,664,658
OTHER $     6,018.14 2,152 $               12,951,037 800 $               4,813,961
RESP $     6,118.73 677 $                 4,142,380 197 $               1,202,960
Total Inpatient Earnings 9,506 $               50,155,710 4,664 $             24,220,949

 

Expenses Worksheet, Mid-Year Review
Inpatient
Inpatient Product Line Budget/RWP
(FY10)
Actual RWPs
(FY10)
IP Expenses
(FY10)
Forecasted RWPs
(FY11)
FY11 Budget
(FY10+6% Inflation)
Actual RWPs
(FY11 YTD)
Actual IP Expenses
(FY11 YTD)
CIRC $   5,475.81 690 $   3,778,309 724 $             4,202,356 421 $               2,472,822
DIGEST $   5,476.81 1,105 $   6,051,875 1,161 $             6,737,188 636 $               4,356,173
ENT $   5,477.81 124 $       679,248 130 $                 754,842 72 $                 462,822
GYN $   5,478.81 208 $   1,139,592 219 $             1,268,947 116 $                 777,322
MENTAL HEALTH $     498.78 1,287 $       641,930 1,351 $                 714,283 736 $                 400,730
NERVOUS $   5,478.81 217 $   1,188,902 228 $             1,324,119 112 $                 675,173
NEWBORN $   5,478.81 698 $   3,824,209 733 $             4,256,926 433 $               2,971,020
OB $   5,478.81 1,430 $   7,834,698 1,501 $             8,717,115 868 $               5,472,892
ORTHO $   5,478.81 601 $   3,292,765 631 $             3,664,557 274 $               1,771,063
OTHER $   5,478.81 2,050 $   11,231,561 2,152 $             12,497,823 800 $               4,662,277
RESP $   5,478.81 645 $   3,533,832 677 $             3,931,704 197 $               1,233,771
Total Inpatient Expenses $   43,196,922 9,506 $             48,069,860 4,664 $             25,256,062

 

 

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