$150/patient

Started by BAM!
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BAM!

Senior Member
20+ Year Member
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I was thinking about an old thread from 2017, "How much are YOU Actually worth?". One of the numbers that stuck out to me was the average national reimbursement of $150 per patient. Is this number still relevant in 2020?
 
I was thinking about an old thread from 2017, "How much are YOU Actually worth?". One of the numbers that stuck out to me was the average national reimbursement of $150 per patient. Is this number still relevant in 2020?
Yes. It varies by region and by sub-regional payor mix. Several hospitals in my neck of the woods currently have variations between 140 and 190 depending on site/acuity/payor mix.
 
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Yes, but it's so widely variable that it almost makes it worthless. The best sites can be making $200-225/pt with great payor mix, higher acuity etc. Low acuity, Medicaid, lots of uninsured (especially who don't pay their bills...we actually have an excellent collection ratio and get more $/case than private insurance for some crazy reason) and you can end up below $100/case. Lowest I've seen was about $85/case? Net operating revenue is what really matters and that's your collections - expenses so admin, billing, malpractice, local site expenses can all add up there too and make up for some of the difference. And that's just the $/patient encounter. The other half of the formula is volume. Is it a slow site, busy site, do you benefit from shared production with APP (ie patients/hr/MD hour which is just as important as your patient/hr.
 
ONe thing to keep in mind is the profit from MLPs too.

I have heard and know the range on per patient collections is $85 to $330. The thing to also consider if the company is getting a stipend. FOr example at one site I know TH gets over $2m in subsidy which equates to $70 per patient. If they do 2 pph that's $140 per hour just in subsidy money. They pay these docs about $200-$210/hr.

The payer mix is fairly crappybut I'm sure they have $50-80/hr in profit. I don't know the MLP stating at this particular place.