GP1 Report - Group Number 8 (final)- Checked
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Group Number 8
Group Project 1 Mini-Case 1: Payment to Providers
This case shows how Managed Care pays its primary care physicians by capitation, but a percentage amount is withheld and distributed based on performance. This is to show the importance of the financial goal that Managed Care is trying to achieve from specialty care and costs less than budgeted. Therefore, Managed Care provides a financial incentive to its PCPs to encourage the careful referral of patients to other services. The financial incentive is based on the
referral gain or loss which is defined as the difference between the actual and budgeted specialty care and hospital cost. The 3 risk-sharing rules are as follows:
If there is a total referral gain, then all of the total withhold is returned to the PCPs based on the number of patients per PCP.
If there is a total referral loss that is less that the total withhold, then the difference (withhold – referral loss) is returned to the PCPs based on the number of patients per PCP.
If there is a total referral loss that is greater than the total withhold, then none of the withhold is returned to the PCPs
Based on the calculations and the information gathered the PCP capitations payment PPPM was $20, from which 15% was placed into the PCP risk pool. The specialty/hospital budget PPPM was $50 and this data was recorded at the end of the year, considering that the number of months
per year would be 12.
A. Calculate the withhold returned to each PCP at the end of the year.
The results were that Dr. Adams was the only one who didn’t receive his withhold due to the referral losses that didn’t match the number of patients he referred. While the other three doctors did get their withhold returned from being paid by capitation. B. Calculate the total compensation of each PCP at the end of the year.
To calculate the total compensation of each PCP at the end of the year, we take the initial allocation they started and, if they met the risk-sharing rules performance, add their withhold returned at the 15% withhold rate used for the risk pool.
C. Was each of the PCPs fairly compensated?
To answer this question, we must look at the following data recording for the four PCPs at Managed Care at the end of the year. Dr. Adams referred to 600 patients with the referral costs being $504,000. Dr. Baker referred 800 patients with a referral cost of $470,000. Dr. Cage referred to 1,000 patients with $590,000 costs of referral, and lastly Dr. Dove referred the greatest number of patients which was 1,600 and the referral costs being $880,000. The $20 PPPM is a good amount out of the $50 of the specialty/hospital budget. This incentive is seen as a payment that’s seen as very reasonable. Although PCPs sometimes can’t control the losses that happen in referring patient, this is something that should be investigate so there can be more
Group Number 8
accommodations for PCPs as they have the potential to be rewarded from the risk pool based on their performance of encouraging PCPs to be careful in referring patients to services.
D. What incentives does this single risk pool based on aggregate PCP performance present to the individual PCPs?
The incentives that this single risk pool based on aggregate PCP performance present to the PCPs is that they can get back the withhold that was used by capitation. Capitation helps to reduce high costs that are associated with overspending on unnecessary services. E. What should be investigated to assess the fairness of the PCP compensation?
What should be investigated to assess the fairness of the PCP compensation are the losses
that cost the hospital and the reasons they happened. For example, in the case of Dr. Smith, he had to lose his withhold of $21,600 because his referral loss did not meet the performance needed. Dr. Adams would’ve gotten his withhold if he had a higher number of patients, but other
factors must be considered for the reason why he had fewer patients and why his referral loss was greater than the other PCPs.
Mini-Case 2: Financial Risk and Required Return
From this mini-case we
are
assumed that as financial planners our first assignment is to invest $100,000 for a one-year holding period. There are 5 investment stock companies that show their probabilities and outcomes. From the information gathered from the expected rate of return, standard deviation, coefficient variance, and beta; we conclude that the stock that should be invested in and has less risk would be T-Bills. Even though T-Bills have the lowest expected rate of return meaning that not much will be gained, there is strong data to indicate that the money invested won’t be at risk if the market economy ends up going into a recession or fluctuates.
The highest expected return was Alta Ind which was at 17.40% though it has the greatest loss if a recession occurs but has the greatest profit when the economy is booming. T-bills, on the other hand, has the lowest expected return rate which stays the same no matter what the state of the economy is. Repo men have the greatest chance to be able to succeed when the economy is in a recession at 28.0% but it’s at its worst when the economy is booming from 20.0%, which this company has the greatest outliers out of the other potential stock investment. This may be due to which this company’s purpose is to collect debt which is the reason why they do so well during the recession period.
The expected return is a speculative financial metric investment tool that can be used to determine where to invest money. By calculating the expected rate of return on an investment, investors get an idea of how that investment may perform in the future. This financial concept can be useful when there is a robust pool of historical data on the returns of a particular investment. Investors can use historical data to determine the probability that an investment will perform similarly in the future.
Group Number 8
However, it’s important to remember that past performance is far from a guarantee of future performance. Investors should be careful not to rely on expected returns alone when making investment decisions. Therefore, we must also look at the standard deviation, coefficient of variance, and beta to assess the risk of investing in any of these 5 stock companies.
E. Do the standard deviation, coefficient of variation, and beta produce the same risk ranking? Why or why not?
The standard variation, coefficient variance, and beta do not produce the same risk ranking as what is shown in the table. SD and CV measures stand-alone risk. SD considers the expected return and CV considers both the expected value and the dispersion of the distribution. Lastly beta measures the overall risk of the market, it shows the relationship between a given stock and the general stock market. Standard variation is used as a represented risk; whichever investment is considered low risk should be chosen. For the coefficient variance, we see that whichever has the lowest is related to which of the stocks would be the best to invest in. For beta, we see that if it’s considered negative then it should not be part of the portfolio and is best to be avoided since it has the greatest market risk.
F. Suppose you create a two-stock portfolio by investing $50,000 in Alta Industries and $50,000 in Repo Men. Calculate the expected return, standard deviation, coefficient of variation, and beta for this portfolio. How does the risk of this two-stock portfolio compare with the risk of the individual
stocks if they were held in isolation?
Alta industries is an electronics firm while Repo Men Inc. collects past-due debts. Since these two stocks are opposite from one another or, in other words, are negatively correlated to one another, this can be beneficial as when Alta Ind. is not doing good in the stock market then Repo Men will probably be at its peak, and vice versa. Now, looking at the results we got from the portfolio weight, estimated portfolio return, and other variables that were solved, we can see that by investing in both of these stock companies we might be able to have the greatest amount of return if the state of the economy is right in the middle which means it should not be close to a recession or close to a booming economy.
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Group Number 8
Mini-Case 3: Lease Financing
In this final case, we are asked to analyze the lease-versus-purchase decision from Bolden
Health System Inc. when acquiring a new electronic heath record system for its Rio hospital. If Bolden decides to purchase, they could obtain a term loan for the full price of $1,000,000 at a 10 percent interest rate and the equipment would be sold after four years for an estimated residual value of $200,000. It would be necessary to purchase a 4-year maintenance contract for $20,000. This system is classified as a special-purpose computer, so it falls into the MACRS three-year class. The lease option is for a 4-year guideline lease, which includes maintenance for $260,000 at the beginning of each year. Bolden’s marginal federal-plus-state tax rate is 40 percent.
Using the information gathered we can calculate how much it would cost to own or rent the unit taking into consideration the purchase cost, maintenance cost, tax savings, depreciation tax savings, and residual value. Based on the information, it would be best to lease the equipment as that would be the most cost-efficient option. The NAL is always positive, reinforcing the idea that leasing would be the best option as it shows the price difference that favors leasing over buying. E. Do the changes in d. make leasing more or less attractive? Explain.
If the pre-tax interest were to change, there would be no change to the final NAL as the tax rate used to make calculations is the 40 percent federal-plus-state tax. If the federal-plus-state tax were to be lowered, that would decrease the maintenance tax savings,
the depreciation tax savings, and the tax on the residual value of the purchase, resulting in decreasing the cost of owning and reducing the NAL but it would still be a better option the lease.
If the maintenance cost were to increase, the maintenance tax savings would increase but the overall cost of purchase would increase as well. This results in a greater price difference between
buying and leasing, making leasing an even more attractive option. If the residual value were to be lowered, meaning that now the system was to be sold, the value would decrease, lowering the money it would return. This would increase the cost of owning, making leasing the best option. The NAL would more than double. If the system price increased, that would increase the cost of owning it as it would increase the amount of money needed to acquire the system. Taking into consideration that the lease amount would be a fixed amount, not changed by the change in the price of the unit, leasing would be cheaper in this case and the best option.
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