CMD Financial Management & Budgeting in Healthcare 3

Question 1

A skilled nursing facility has a contribution margin of $45 per patient day and fixed costs of $900,000 annually. What is the break-even volume in patient days?

Accepted Answer

20,000 patient days

Answer

Break-even volume = Fixed costs / Contribution margin = $900,000 / $45 = 20,000 patient days.

Question 2

Which financial statement summarizes a healthcare organization's revenues, expenses, and net income over a specific time period?

Accepted Answer

Income statement (statement of operations)

Answer

The income statement (or statement of operations) reports revenues and expenses over an accounting period, showing net income or loss.

Question 3

A medical director is reviewing payer mix data. The facility has seen a 10% shift from commercial to Medicaid patients. The MOST likely financial impact is:

Accepted Answer

Decreased net revenue per case due to lower Medicaid reimbursement rates

Answer

Medicaid typically reimburses at lower rates than commercial payers, so a shift toward Medicaid reduces net revenue per case.

Question 4

Cost-shifting in healthcare occurs when a provider:

Accepted Answer

Charges higher rates to one payer group to compensate for lower reimbursement from another

Answer

Cost-shifting means recovering losses from underpaying payers (like Medicaid) by charging higher rates to other payers (like commercial insurers).

Question 5

In a capitated payment model, the provider receives:

Accepted Answer

A fixed payment per member per month regardless of services used

Answer

Capitation pays a fixed per-member-per-month (PMPM) rate, transferring utilization risk to the provider.

(CMD) Certified Medical Director Practice Test

(CMD) Certified Medical Director Practice Test

CMD Financial Management & Budgeting in Healthcare 3