Question

The Citizen Hines HMO uses primary care provider (PCP) contracts that set the PCP capitation rate at $15 per member per month (PMPM). Citizen Hines also contributes $45 PMPM to an institutional inpatient services risk pool and $30 PMPM to a specialist services risk pool. In addition, the contract includes a provision requiring a 20% withhold.

If PCP Physician A has 100 Citizen Hines subscribers on her member panel, what is Physician A's expected annual compensation from Citizen Hines HMO?

Group of answer choices

$16,800

$21,600

$15,000

$18,000

Answer 1

Capitation rate per member per month = $15

No of members = 100

Physician A's expected annual compensation from Citizen Hines HMO = $15 * 12 months * 100 members

= $ 18000

However, the contract includes a provision requiring a 20% withhold.

Therefore, annual compensation = $18000 * 80/100

= $ 14400