Because many individuals moved in and out of Duval and Broward Counties and/or changed eligibility during this time, only those months where the individual lived in one of the Demonstration counties and was in a Demonstration eligible category were used to calculate baseline PMPM
Although participants in general had slightly lower costs and utilization as measured by inpatient admissions, emergency room visits, and PMPM
costs, the differences were no longer statistically significant.
Unlike traditional short-run CVP analysis, which typically shows revenues and costs in total for the whole organization, the strategic SPCM model presents the GM and SG&A costs for each product and customer on a PMPM
basis to be consistent with the industry standard.
Specifically, Figure 4 shows the changes in the PMPM
drug costs, other medical costs, and total costs that result when the initial uptake of rFVIIa increases and decreases.
Finally, payments for healthcare services PMPM
by the Federal Employee Health Benefits Plan (FEHBP) constitute a third cost indicator.
In the second simulation, PMPM
charges were truncated at three standard deviations above the mean for each specific ACG.
Arnett's costs include the monthly PMPM
fee to StatusOne for ongoing, monthly updates of our registry and use of the CareLink software.
7 million are impressive, they are a tiny fraction of the more than $17 billion that calculates to exorbitant costs of care PMPM
PCMPs are reimbursed on a FFS basis for medical services and receive a PMPM
medical home payment.
For PSNs, PMPM
expenditures were the sum of all paid amounts for claims in a given month, including a monthly patient case management fee paid to PSN providers, while for HMOs the PMPM
expenditures were simply the monthly risk-adjusted capitated premiums.
Of the average rebate payment of $87 PMPM
, plans projected they would allocate about $78 PMPM
(89 percent) to reduced cost sharing and reduced premiums and $10 PMPM
(11 percent) to additional benefits.
This is achieved through contracting, either to a payer, a hospital, or whomever has the control over the PMPM