What amount of shared savings will you have to pay back to the insurer due to your downside risk?Explain your logic for each step.
Description
Referring to the Module 4 Supplemental PowerPoint (slide 24), respond to the following:
You are the director responsible for the success of your health system’s commercial ACO contracts. You’ve done a great job with quality so your focus turns to your shared savings.
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Order Paper NowYou need to report back to your leadership on your two largest ACO arrangements. The financials are as follows:
Arrangement #1:
Total Attributed Population: 30,000 patients
Agreed Upon Budget: $165 Million
Percentage of Risk: 30% upside and 10% downside
Results:
Medical PMPM: $310
Pharmacy PMPM: $112
What is the shared savings amount your organization can expect?
Arrangement #2
Total Attributed Population: 45,000
Agreed Upon Budget: $230 Million
Percentage of Risk: 35% upside, 12% downside
Results:
Medical PMPM: $350
Pharmacy PMPM: $115
What amount of shared savings will you have to pay back to the insurer due to your downside risk?
Submit your response in a Word document. Include your calculations for each arrangement and explain your logic for each step.
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