I don't like to think about the blog on weekends - hey, we're busy preparing for Nowruz! - but I saw this post from Dr. Russell Libby and had to share it. I wish I had thought to do a similar calculation, but the credit goes to him:
No question about the "new" math. If a practice has no Medicaid
patients because the state pays at 30% less than their ins reimbursed
rates and they decide to go after the stimulus $ what happens? If we
gross $5Mil/yr in a 10 FTE practice and could find enough Medicaid
patients in our neighborhood to reach 20% of our revenues (it would
be impossible to identify them as 20% of our patient population) that
would be, assuming 2500pts and 5000 visits/FTEMD/yr, that would be
5000 new Medicaid patients and 10,000 visits for the group to have
all of the docs qualify for the EMR money. (I would consider it a
true banner year if I could find so many new patients and get them in
at such a frequency.) Assuming that the average revenue/pt visit is
$110 (taken from the most recent surveys in the AAP database), a 30%
hit on that average ticket would be $330K and that would be on a
yearly basis, so that over the 5 years you got the, let's be
unrealistic and optimistic, $70K/MD or $700K to the practice, it
would cost $1.65 mil in lost revenue. I know, too many assumptions,
but the reality is that no matter how you dice it, for those of us
who can't afford to have a large Medicaid patient population, the
stimulus money is not really anywhere near the table.
The OCD part of me wishes to point out a few things:
BUT IT DOESN'T MATTER. His premise is still completely correct, the nitpicks above actually negate each other (I'm sure he knew that and was trying to keep it simple), and I applaud him for pointing out the issue. Good work.