CASCADES MENTAL HEALTH VARIANCE ANALYSIS CASCADES MENTAL HEALTH Clinic is a not-for-profit, multidisci- plinary mental health provider that offers both inpatient and outpatient services on a full-risk (capitated) basis to members of managed care plans. Its clinical staff consists primarily of psychiatrists, psychologists, psychiatric nurses, social workers, and chemical dependency counsel- ors. Currently, Cascades has major contracts with two large managed care organizations in its service area: Pacific Care and Seattle Health- plans. Each of these organizations has both commercial and Medicare health maintenance organization (HMO) contracts with Cascades. Thus, in total, there are four separate product lines. Cascades is partially funded by state and local government. The agreement with the funding agencies is that funds received are to be used to cover overhead and capital expenses. Furthermore, expenses for drugs and other medical and administrative supplies are billed separately to the HMOs at cost. Thus, overhead and supplies expenses are not part of this budget, which means that the analysis focuses on clinical labor expenses. If the assumption is made that other payment mechanisms cover overhead, capital expenses, and supplies at cost, then Cascades' profitability is solely a function of its ability to create revenues that exceed labor costs. Thus, its operating budget focuses on enrollment, per member premiums, utilization, and labor costs. Exhibit 7.1 lists the assumptions used to prepare Cascades' 2013 operating budget. Note that the four product lines are expected to provide a total of 4,551,000 member-months of revenue during 2013. Also, note that each product line has a different per member per month © HAP, 2014. Reproduction without permission is prohibited.