You are the administrative assistant to the president of BCC Health Plan, a small HMO located in the Midwest. The president has presented you with the following selected information regarding the organization’s operating results for the previous quarter. The president has asked you to review the data and prepare a summary report of the variances (e.g., enrollment and utilization) for next week’s board meeting. Data for the Quarter Ended September 30, 2011 Budgeted Actual Enrollees 10,000 12,000 Inpatient days per 1,000 enrollees 600 650 Total inpatient days 6,000 7,800 Outpatient visits per member 5.0 4.0 Total outpatient visits 50,000 48,000 Cost per inpatient day $1,000 $1,200 Cost per outpatient visit $65 $60 Inpatient costs $6,000,000 $9,360,000 Outpatient costs $3,250,000 $2,880,000 Total costs $9,250,000 $12,240,000 Per member per year costs $925 $1,020 Write your summary report of the variances. 1. Do you think the budget was flawed? Explain your answer. 2. What might account for the increase in the number of enrollees? Could it have been foreseen? 3. What might account for the increase in the number of inpatient days and decrease in outpatient visits? Could these have been foreseen? 4. What might account for the increase in cost of inpatient days and decrease in cost of outpatient visits? Could these have been foreseen? 5. What research may be done to explain these variations?
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