A Financial Analysis of Procedural Revenue in Outpatient Spine Clinic: An Analysis of 36,312 Patient Appointments and Subsequent Surgeries at a Single Major Academic Institution

Benjamin S. Hopkins*, Aditya S. Mazmudar, Prithvi R. Bomdica, Tyler Robert Koski, Alpesh A Patel, Nader S Dahdaleh

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The economic pressures widely discussed in health care have a large impact on spine practices. This current study is the first to look at characteristics associated with revenues from an outpatient spine clinic. Methods: All clinic visits to spine providers were identified at a single academic institution spanning the dates June 1, 2014, to June 1, 2018. All payment information was calculated using Medicare reimbursement values for Current Procedural Terminology codes. Relevant clinical, surgical, and cost structure data was collected for each patient. Results: On average, providers had 21.9 average appointments over the course of 7.6 hours per clinic day. The average ratio of new to follow-up patients was 39.3%, with an average new patient to surgery conversion rate of 15.0%. The adjusted average total procedural revenue per new patient, controlled for scheduled appointment length and actual appointment length, was $686.02. The adjusted average procedural revenue per surgery was $3444.64 and average procedural revenue per hour in spine clinic was $552.40. With a 1% and 5% increase in new patient visits, total procedural revenue increases 2.7% and 13.5%, respectively. With a 1% and 5% increase in conversion rate, total procedural revenue increases 6.7% and 33.3%, respectively. With a decrease in new patient appointment length from 30 minutes to 25 minutes, the opportunity for 1.7 new patient appointments per day was created resulting in a net increase in procedural revenue per clinic day of $837.57. Conclusions: Incremental changes in practice structure can significantly affect procedural revenue. Significant heterogeneity also exists among spine providers.

Original languageEnglish (US)
Pages (from-to)e938-e943
JournalWorld neurosurgery
Volume128
DOIs
StatePublished - Aug 1 2019

Keywords

  • Cost effectiveness
  • Health economics
  • Hospital costs
  • Outpatient spine clinic

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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