1. A nursing home contracts with an HMO for skilled nursing care at $2.50 PMPM. If costs are expected to average $150 per day, what is the maximum utilization of days per 1,000 members that the nursing home can experience before it begins to lose money?
2. An HMO has a Point of Service (POS) option for its members, but will pay only 80 percent of approved charges. If a member goes out of network for a medical procedure with a charge of $3,000, of which $2,000 is approved, how much must the member pay?