Hospital facility collections -pain

[bedrock]

Can anyone tell me what is the average annual hospital facility fee collections would be for a busy pain doc? (who is at 90% of wRVU)

I might do a wRVU model with a hospital near a satellite clinic for just 5 days per month, and I’m trying to understand how much the hospital will make for those 5 days so I understand my leverage.

I know hospital make “a killing” with their SOS , I’m just not sure how much.

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[SC Tian]

are you doing procedures in hopd or asc?

 

[bedrock]

are you doing procedures in hopd or asc?

I’m currently in pp ASC. This potential deal would be 25% of my time doing HOPD procedures.

 

[jsaul]

Good luck trying to do facet procedures in hopd

 

[SC Tian]

Some regulations restrict having a hopd surgical center outside of the main campus of the hospital. Efficient of working in a hopd surgical center can be difficult. I know more information about ASC setting.

 

[RoloTomassi]

I’m currently in pp ASC. This potential deal would be 25% of my time doing HOPD procedures.

Assuming you know your annual ASC collections you could extrapolate. Look at your top 5 procedures, and let's say they average 2x in HOPD vs ASC, 25% cases would be about half you current annual ASC collections

 

[Ferrismonk]

Good luck trying to do facet procedures in hopd

We do it every day.

 

[cowboydoc]

Good luck trying to do facet procedures in hopd

Did 5 this a.m. That said, the new CMS pre-auth requirements are ridiculous. (see other threads)

OP-make sure you have a good prior-auth team in place as part of this setup for the aforementioned.

Some things have apparently been not getting paid. Just brought to my attention in passing. They make so much per injection, they don't care if they get skunked sometimes...

 

[clubdeac]

HOPD makes 2-3K per injection, it's unreal

 

[Ronin1]

HOPD makes 2-3K per injection, it's unreal

Not for Medicare. Faculty fee for epidural is about 644.

1750 for RFA

Procedure Price Lookup for Outpatient Services | Medicare.gov

Use official Procedure Price Lookup tool to compare national average to Medicare costs in ambulatory surgical centers, hosptial outpatient departments

www.medicare.gov

 

[bedrock]

Not for Medicare. Faculty fee for epidural is about 644.

1750 for RFA

Procedure Price Lookup for Outpatient Services | Medicare.gov

Use official Procedure Price Lookup tool to compare national average to Medicare costs in ambulatory surgical centers, hosptial outpatient departments

www.medicare.gov

Thank you. I thought it was more $ than that.

I’m really curious how much hospitals collect with a BCBS patient for a facility fee from for epidural and particularly for an ablation.

 

[cowboydoc]

Thank you. I thought it was more $ than that.

I’m really curious how much hospitals collect with a BCBS patient for a facility fee from for epidural and particularly for an ablation.

Patient reported $1700 out of pocket for tfesi the other day. He seemed a bit less pissed at me when I said I get paid ~$125.

 

[bedrock]

Any other data points people can share regarding HOPD facility payments? Particularly for commercial (non Medicare insurance)?

I’m going to meet with the hospital CEO this week to discuss this. An introductory meeting, but still I’d like some more financial information to share with them regarding facility payments.

I plan to ask for a lot more than $65 per wRVU.
The hospital doesn’t currently offer pain procedure beyond simple ILESI by radiology. The hospital wouldn’t be paying me benefits and they also don’t have to pay for a clinic or for marketing, as I will be bringing the procedure patients to them.

 

[SgtThunderfistMD]

You are not gonna make (*a lot*) more than $65/rvu unless you are in BFE. They get that number from MGMA, and the median pain doctor gets paid ~$65/RVU so that's what they offer. More than a lot on this forum get.

 

[DOctorJay]

You are not gonna make (*a lot*) more than $65/rvu unless you are in BFE. They get that number from MGMA, and the median pain doctor gets paid ~$65/RVU so that's what they offer. More than a lot on this forum get.

national median is currently $69.91/wRVU

 

[BobBarker]

I would ask for $100/rvu if they aren’t providing benefits, med mal, etc.

 

[clubdeac]

national median is currently $69.91/wRVU

Do you happen to have the source. I may need this information in the next few months. hopefully not though

 

[DOctorJay]

Do you happen to have the source. I may need this information in the next few months. hopefully not though

the source is MGMA
you can purchase the full data set at www.resolve.com

 

[bedrock]

I would ask for $100/rvu if they aren’t providing benefits, med mal, etc.

Thank you. This town of this hospital is somewhere I drive one day per week is quite rural.

It’s a 90 min drive one way. Thankfully just one day per week.

But they have basically zero other options for pain, so I think 100/RVU is reasonable. One of our orthopedic surgeons did some similar for one day per week going to a different rural hospital in different town and he is getting $130/rvu from them.

 

[cowboydoc]

Thank you. This town of this hospital is somewhere I drive one day per week is quite rural.

It’s a 90 min drive one way. Thankfully just one day per week.

But they have basically zero other options for pain, so I think 100/RVU is reasonable. One of our orthopedic surgeons did some similar for one day per week going to a different rural hospital in different town and he is getting $130/rvu from them.

That sounds like a good place to start.

 

[BobBarker]

$130/rvu for pain would be good then. Pain is more profitable than ortho by a lot. They make $700 facility fee on an ESI that costs $10 in supplies.

 

[MitchLevi]

90 min one way is absolutely brutal. They should reimburse you for fuel as well.

 

[BobBarker]

I would position this as a pain services agreement. You are the director. You can do the procedures yourself or have a qualified designee perform them. You will be compensated $130/rvu but you will assist them with staffing efficiency, cost of supplies, best practices (avoiding sedation), imaging/pt, feed ortho, etc. If you do your part and they allow you to lead, you will be the most important person at the hospital. You will build it up to 2 full days a week quickly and then hire an associate to be there 3 days a week and at the main office 2 days a week.

This is the way.

 

[Ducttape]

just make sure they dont try to sneak in any inpatient work.

 

[BobBarker]

just make sure they dont try to sneak in any inpatient work.

In Colorado, midlevels can prescribe schedule 2’s and do not require supervision. A midlevel provider can be provided for $325,000 annually for any in patient needs.