Healthcare Finance

Use the following information to answer questions 1 and 2:

You have been asked to establish a pricing structure for radiology on a per-procedure basis. Present budgetary data is presented below: Number of Budgeted Procedures 10,000 Budgeted Cost $400,000 Desired Profit $ 80,000 It is estimated that Medicare patients comprise 40 percent of total radiology volume and will pay on average $38.00 per procedure. Approximately 10 percent of the patients are cost payers. The remaining charge payers are summarized below: Payer Volume% Discount % Blue Cross 20 4 Unity 15 10 Kaiser 10 10 Self-Pay 5 40 50% Your supervisor recommends the following method to set the rate per procedure in order to generate the required $80,000 in profit: Weighted Discount = (0.4 × 0.04) + (0.30 × 0.10) + (0.20 × 0.10) + (0.10 × 0.40) = 0.106 Price = ($400,000 ÷ 10,000) + [($80,000 + 4,000 ($40.00 – $38.00)) ÷ 5,000] 1 – 0.106 =($40.00 + $17.60)/.894 = $64.43

2. If the forecasted volume increased to 12,000 procedures and budgeted costs increased to $440,000, while all other variables remained constant, what price should be established?

3. Assume that the only change in the original example data is that Blue Cross raises their discount to 20 percent. What price should be set?

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