For this assignment you will complete Case #3 Santa Fe Healthcare Capitation & Risk Sharing from the Gapenski text Cases in Healthcare Finance, 6th Ed. You will be working in your 7537 Small Groups.
This case requires students to examine the issues involved with payment allocation and risk sharing within a Physician Hospital Organization (PHO). The model calculates the dollar distributions to each provider category and the budgeted and actual total reimbursement for the PHO’s primary care physicians, specialist physicians, and hospital. In addition, the model provides the calculations for two illustrative risk pools.
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