How much revenue do we generate?

[Pharmado]

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How much $$$ can a group realistically expect to collect from a provider in a 3:1 ACT model working 50ish/wk with 8-10 wks vacation in a for profit hospital with a good payer mix vs a nonprofit with a poor payer mix? What about if this were a solo practice in a for profit vs nonprofit?

 

[Mikkel]

There are so many factors involved that no numbers would give you a good picture.

 

[deleted162650]

Plenty of non-profit hospitals out there with good payer mixes and vice versa.

 

[EtherLord]

How much $$$ can a group realistically expect to collect from a provider in a 3:1 ACT model working 50ish/wk with 8-10 wks vacation in a for profit hospital with a good payer mix vs a nonprofit with a poor payer mix? What about if this were a solo practice in a for profit vs nonprofit?

What do you mean by “working 50 hours per week?” Is this on-site work with all 3 rooms running during this time? Or does this include some sort of standby time?

 

[nimbus]

Figure 50units/room/day for a typical 7am to 5pm day. Some rooms generate more, some less depending on acuity (base units/lines/blocks) and downtime(turnover).


For 5 days work you get,

At $30/unit->$7500/week/room
At $40/unit->$10000/week/room
At $50/unit->$12500/week/room

If you are supervising CRNAs, you need to subtract their salary and benefits. So a doctor supervising 3 average rooms generates $30000/week in collected revenues. Subtract $12000-15000/week for the salary and benefits of 3 CRNAs. That still leaves $15000-17000/doc/week if the practice is collecting $40/unit. Then ask where the rest of the money goes.


Don’t forget night and weekend work and hospital stipends which can add another 20% to the top line.

 

[Pharmado]

So a group with equal profit sharing would generate in the neighborhood of
15k/wk x 40wks = 600k per partner at a 12 wks vacation plus whatever is generated for call and weekends, minus the group overhead. At $30/unit it’s closer to 450k, $50/unit it’s more in the range of 750k.

 

[nimbus]

So a group with equal profit sharing would generate in the neighborhood of
15k/wk x 40wks = 600k per partner at a 12 wks vacation plus whatever is generated for call and weekends, minus the group overhead. At $30/unit it’s closer to 450k, $50/unit it’s more in the range of 750k.

Yes assuming supervision ratio 1:3 and CRNAs are getting paid $200k/yr.

 

[unkemptmiso]

About $3.50

 

[Consigliere]

A lot

 

[kmurp]

I would guess gross income before any expenses of about 1.5 million. Subtract out billing/administration, CRNA salary AND benefits (which is over 200 where I work), CRNA overtime pls vac coverage cost for docs and crnas.

 

[pjl]

CRNA total package around here is a lot closer to 3 than 2. They also get paid whether rooms are 50 units or 0. Running a room from 7-5 x5 days =50 hours, our CRNAs are 40/week. In the example above you need 3.75 CRNAs per week, not 3.

Admin/billing costs are not negligible either.

There are a lot of variables that are frequently not accounted for in these examples.

 

[nimbus]

CRNA total package around here is a lot closer to 3 than 2. They also get paid whether rooms are 50 units or 0. Running a room from 7-5 x5 days =50 hours, our CRNAs are 40/week. In the example above you need 3.75 CRNAs per week, not 3.

Admin/billing costs are not negligible either.

There are a lot of variables that are frequently not accounted for in these examples.

If you need one anesthesiologist plus 3.75 CRNAs at 300k/yr to cover 3 rooms, it seems like it would be easier to go with 3 MDs.

 

[kmurp]

We would calculate it at 3.34 CRNAs to cover the rooms for 52 weeks which would account for CRNA vacations. 1.15FTE MD for 52 weeks. The Docs in our group do all the rooms after 3:30. If you use CRNAs for this, your cost will go up either due to OT or extra FTEs. Billing and administration expenses are between 5 and 10% of the gross depending on the group. I don’t think you can run a group with CRNA employees administering their payroll, benefits and doing contract negotiations for much less than that unless the group was rather large and had economies of scale.
If the three rooms generate 1.5 million, at 7% overhead and 8 weeks vacation, the roughly 1.4 million after overhead is available to pay 3.45 FTE anesthesiologists to account for vacation which is $406,000 total comp per doc.
With 1:3 and CRNA total comp at, lets say, 275,000, the 1.4 million is minus $918,000 for the CRNAs leaving $481,000 for the 1.15 FTE MD needed which is $418,000 per MD total compensation.
So in this example 1:3 is no better than all MD. 1:4 would be a better choice if the goal was to maximize MD compensation.

 

[pjl]

If you need one anesthesiologist plus 3.75 CRNAs at 300k/yr to cover 3 rooms, it seems like it would be easier to go with 3 MDs.

Agree, and that is not how we run it.