Calculate the amounts paid to the primary care physicians (PCPs) and specialty care physicians (SCPs) if the following withhold system is in place.

    PCP                   SCP

Payment                                     $38 PMPM         $70 per visit

Annual Budget (10,000 lives)     $4,560,000         $1,050,000

Withhold                                              10%                      20%

Risk Pool                                      $456,000             $210,000

Split                                                     68.5%                    31.5%

A. Assume that actual billings correspond exactly to the budget, i.e. total SCP billings equal $1,050,000 (15,000 visits).

B. Assume that the use of specialist services is less than planned, i.e. total SCP billings equal $980,000 (14,000 visits).

C. Assume that the use of specialist services is greater than planned, i.e. total SCP billings equal $1,260,000 (18,000 visits). What is the marginal revenue per specialist visit in excess of the planned 18,000 visits?