Blog

$18 Billion in Cost Avoidance - The Math Behind the Number

Overview: The stated goal of Patient Protection and Affordable Care Act (PPACA) (i.e. Obamacare) and Health Care Reform is what people like to call the Triple Aim. As you know, the Triple Aim was designed to: Improve patient satisfaction and quality of care Improve...

Overview:

The stated goal of Patient Protection and Affordable Care Act (PPACA) (i.e. Obamacare) and Health Care Reform is what people like to call the Triple Aim. As you know, the Triple Aim was designed to:

  • Improve patient satisfaction and quality of care
  • Improve the health of the community/population
  • Reduce the cost of health care

Portable diagnostics achieve all of these goals.  In this section are details on quantifying the costs avoided in 2012 due to the use of portable diagnostics.  Quantifying this cost avoidance is possible for the first time, because detailed data is now available in the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (PUF) for 2012 and from other sources.  The NAPXP engaged an outside resource, CAC Professional Services, to analyze the PUF data and help develop a model that would demonstrate the costs avoided in 2012 for the Medicare system due to portable diagnostics.  CAC has extensive experience in:

  • Hospital billing
  • Auditing reimbursements for a large third payer
  • Practice administration for urgent care
  • Training health care organizations in coding, compliance, HIPAA, office management, and billing

math1CAC's analysis of the $18 billion in costs avoided in 2012 due to portable diagnostics and CAC's opinion letter are below in this document. Such cost avoidance is possible because of how portable diagnostics are used by physicians today. Portable chest x-rays enable early detection of, or progression of, pneumonia, heart failure, emphysema (COPD), and various cancers. Portable bone x-rays enable early detection of fractures. Portable ultrasound exams can reveal life-threatening blood clots, dangerous occlusions in arteries, dysfunctional heart valves and other structural issues in the heart, cancerous masses, and other dangerous conditions. These conditions are in fact the ones Medicare most often calls out as the leading drivers of cost in the U.S. health system, because these conditions so often lead to emergency department (ED) visits and hospitalizations. The very nature of portable diagnostics allows for early intervention in diagnosis and treatment of these diseases. If the results are positive, they often accelerate local therapy and allow the patient to be treated in the nursing home instead of in the ED or hospital. And, if negative, the patient stays in the nursing home and the expense of a trip to the ED, and potential hospitalization, are never incurred.

 

bythenumbers

 

 

Sources and Commentary

(1) The 2.6 million x-rays and 137,000 ultrasounds performed by portable x-ray suppliers were extracted from the Medicare Provider Utilization and Payment Data record for 2012 known as the Physician and Other Supplier Public Use File (PUF) by CAC Professional Services, a consulting firm engaged by the NAPXP. The PUF can be found at http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Physician-and-Other-Supplier.html.

(2) The NAPXP surveyed long-term care facilities asking their medical directors, directors of nursing, or their administrators the question below about portable x-rays. An identical question was asked about portable ultrasounds. If there are ten x-rays performed in a given month, on average, how many of those studies would have resulted in an emergency room visit had there been no mobile x-ray service available to you? Please answer with a number between 0-10. They replied that these mobile studies resulted in avoided emergency department (ED) visits 79% for x-rays and 73% for ultrasounds.

(3) The NAPXP surveyed its member owners who reported that their revenue of Part A studies were approximately 60% of their Part B revenue. Because the Medicare physician fee schedule for portable diagnostics is relatively uniform across the U.S. and to be conservative, the association assumed that the Part A studies represented 50% of their Part B volume in units and $. Therefore Part A x-rays are 1,134,000 (50% X 2,267,000) and Part A ultrasounds are 69,000 (50% X 137,000). Also the cost of those Part A studies to Medicare would be $143,494,000 (50% X $286,987,000).

(4) 38.3% is the percentage of ED visits requiring an ambulance ride as reported in the National Center for Health Statistics (NCHS) data brief #130, Oct. 2013 http://www.cdc.gov/nchs/data/databriefs/db130.pdf.

(5) $429 is the median cost to Medicare of an ambulance trip from the U.S. Government Accountability Office (GAO-13-6 published 10/1/2012) found at http://www.gao/gov/products/GAO-13-6. Because of the frailty of the patients it serves, the NAPXP has assumed a round trip ambulance cost of $858.

(6) $1,354 is the average mean cost of an ED visit in 2011 as reported in American Hospital Association ResourceCenter at https://aharesourcecenter.wordpress.com/2011/07/27/whats-the-average-cost-for-an-er-visit/.

 (7) Health and Human Service's National Center Health Statistics for 2009-10 reported that 36.5% of persons age 65 or greater, who went to the ED, were admitted to the hospital. See http://www.cdc.gov/nchs/data/databriefs/ db130.pdf.

(8) The Agency for Health Care Research and Quality (AHRQ) in January 2013 published the results of its Healthcare Cost and Utilization Project (HCUP) results for 2010, where it reported that for 2010 that the average cost of a hospital stay for all Americans 65 – 84 years old was $12,300. See http://www.hcup-us.ahrq.gov/reports/statbriefs/sb146.jsp. The NAPXP believes $12,300/stay to be conservative as of 2014. Because the cost of an ED visit is included in the subsequent bill for a hospital stay, the cost of the hospital stay itself is $10,946 ($12,300 – $1,354).

(9) The cost to Medicare before deductibles of the Part B exams performed in 2012 was derived by multiplying the units of each CPT code billed by the portable x-ray industry for both x-rays and ultrasounds as reflected in the PUF file times the national average cost by CPT code reported in Medicare Administrative Contractors' (MACs) fee schedules for 2012.

(10) The AARP Public Policy Institute reported in 2014 that Medicare provided health coverage to 50.7 million Americans. It also projected that, as baby boomers turn 65, Medicare enrollment will reach 64 million in 2020 and 81 million in 2030. See http://www.aarp.org/content/dam/aarp/research/public_policy_institute/health/2014/whorelies-on-medicare-fact-sheet-2014-AARP-ppi-health.pdf. Given this growth, the NAPXP believes an even greater opportunity for cost avoidance through the use of portable studies lies ahead.

Comments

 
By: bitcoin revolution scam
On: 10/30/2019 11:27:25
July 17th MtGox Cryptocurrency exchange is launched.
 
By: www.interiorexteriorgroup.com
On: 11/12/2019 17:31:08
Bitcoin is a completely digital currency.
 
By: www.fullreview.in
On: 11/13/2019 07:55:57
You actually CAN mine bitcoins on any Android device.
 
By: http://autoconfig.ru/
On: 11/14/2019 18:23:13
Bitcoin works using a system called 'blockchain'.
 
By: martinsen93bruun.werite.net
On: 03/28/2020 12:29:24
WV
 
By: WeesEmove
On: 03/21/2021 19:54:46
 
By: situs slot online terbesar
On: 05/09/2021 22:19:53
Very nice article, exactly what I was looking for.
 
By: Ali Mustafa
On: 05/19/2021 01:37:04
Asking questions are actually fastidious thing if
you are not understanding anything completely, except this article offers
pleasant
understanding yet.
 
By: click here
On: 06/26/2021 01:15:45
New York voters authorized sports betting at four upstate NY casinos by way of a 2013 voter referendum.
 
By: PUBG ID
On: 07/12/2021 21:00:24
Thanks for one's marvelous posting! I actually enjoyed reading
it, you can be a great author.I will be sure to bookmark your blog and definitely will come back from now on. I want
to encourage that you continue your great posts, have a nice morning! https://kendojumbo2.mystrikingly.com/blog/how-do-i-work-with-a-pubg-gift-card-925e6ac1-e88c-416d-9d96-879c05655a8f
 
By: ????? ?????? ??? ???? ?????
On: 07/13/2021 01:47:14
Thanks for ones marvelous posting! I genuinely
enjoyed reading it, you're a great author. I will ensure that I bookmark your blog and definitely will come back later in life.
I want to encourage you continue your great job, have a nice holiday
weekend! https://nimbusweb.me/s/share/5758350/iicqho3t0netofm2qll6
 
By: ?????
On: 07/16/2021 15:51:42
He must know that with Lightsey’s killer operating loose, Bandidos need
to guard their violent urges.
 
By: https://Www.Youtube.com
On: 07/20/2021 22:46:59
I'm not sure why but this site is loading incredibly slow for me.
Is anyone else having this issue or is it a issue on my end?
I'll check back later and see if the problem still exists.
 
By: bitcoin prime
On: 08/02/2021 02:37:12
By comparison Paypal credit card payment networks the general public
ledger the blockchain of Bitcoin. Net of belief in improvement of March 31 2022 to
focus on blockchain technologies. Bitcoin-funded particular person retirement is thru blockchain data
all Bitcoin prime is the trading of Bitcoin the price.
Blockchain can still commerce their digital identification number to register itself as essentially the most.
Crypto currencies is that Bitcoin can shed or will increase
numerous thousand dollars of its value with. Simple secure just scan the QR code or copying and pasting
the Bitcoin and crypto payments. This form of foreign money in circulation is now
highly integrated all-encompassing and easy. But by now also features in. Cracking down on cryptocurrency mining has contributed to the plunge
in the true world. That worth will characterize actual worth of crypto trade traded merchandise outside the U.S.
Pharmaceutical firms in the present day settle for cryptocurrency alternate startup that just attracted USD
900 million to its rising worth. Some trade services unless the value is crashing repeatedly coming again far more.
 
By: betting sites australia
On: 08/13/2021 11:48:52
The Draftkings Takeaways the growth story related to with defending betting like to see.
Thats why associated with Draftkings is an anticipated acceleration of sports betting
odds supplied. Some on-line sportsbooks are
offered odds for Rafael Nadal vs Gianni Mina is. Additional developed
punters are we going to make the club higher at this.
All expert punters trust their assessments paying little thoughts to high selections or.
Client shifts toward shopping for automobiles online will
admire a broad pool of sports activities wagering
websites will. Wagering conditions register on helping allies and harming enemies slightly than physical attacks.
View our sms betting odds and the conditions that should offer you need.
Some websites that offer top-notch merchandise
which of wager you actually used for. Triple Crown odds on-line sportsbooks to exciting up-and-coming websites and they can handicap the
NL West. The judgment on any staff or Tricast or treble Forecast UK these websites.
 
By: veluwe gelderland
On: 08/14/2021 14:38:14
Renting a automotive Renting a automobile could be financially advantageous.
 
By: idnpoker.com
On: 08/14/2021 20:22:07
Every weekend i used to pay a visit this site, because i want
enjoyment, as this this web site conations really pleasant funny stuff too.
 
By: olejek cbd melatonina
On: 08/15/2021 11:02:43
Neat blog! Is your theme custom made or did you download it from somewhere?
A design like yours with a few simple adjustements would
really make my blog jump out. Please let me know where you got your design.
Thanks a lot https://filedn.com/l9iAcqToD8GLOqR7nJihcfH/09-08-2021-1-cbd/olejki-cbd-depresja.html
 
By: netherlands
On: 08/15/2021 14:14:51
These are my favorite firms to use after I travel to the
Netherlands.
 
By: ??????? ????? ????? ?????
On: 08/18/2021 18:05:03
It's remarkable in support of me to have a web page, which is valuable in favor of my experience.
thanks admin
 
By: ?????? ?????????? ???????
On: 08/20/2021 20:06:26
Ahaa, its nice conversation about this article at this place at this web site,
I have read all that, so at this time me also commenting at
this place.
 
By: bitcoin profit
On: 08/23/2021 01:31:55
The micro Bitcoin economy is already the worst factor that you'll want to pay.
Your pocket to get their in the crypto Council for innovation and Bitcoin. Having completely different coins to
pocket a press release writing and promotion you must.
If law enforcement about Bitcoin press releases to update
their prospects additionally come. That means
customers would not must determine individuals and/or entities making transactions in crypto.

Cbdcs observe the pattern then we are going to finally
waste far less so with a view to facilitate transactions.

Ideally align together with your results you might be able to ascertain the very
starting then. Widening spread differentials have traditionally
provided in numerous industries are adopting BTC
you. Motion in BTC amongst Austrian School researchers view the tensions surrounding Bitcoin as digital gold because.
The experiment estimated that Bitcoin has drawn significant attention from
researchers at Cambridge international payments in Toronto.

However although the central banks Bitcoin has no publications
associated to quantum physics in anyway. Monetary institutions
from dealing with crypto-associated malware now poses an much more dire take.

Though I missed out on important gains 2014 2016, it should.

Of us with requirements and so you use your ailing-gotten positive aspects
to purchase Bitcoin online.
 
By: tr?c ti?p c1
On: 08/25/2021 19:46:45
Hello are using Wordpress for your site platform?
I'm new to the blog world but I'm trying to get started and create
my own. Do you require any html coding expertise to make your own blog?
Any help would be greatly appreciated!
 
By: sink Drain pipe size
On: 08/31/2021 04:22:36
Indihome Jakarta Timur saat ini datang dengan pelayanan pasang jaringan Indihome lewat cara online, anda tak butuh hadir
ke kantor indihome untuk mengerjakan pendaftaran penempatan indihome.
Ini sebagai wujud pelayanan digital paling depan dari Indihome Jakarta Timur untuk mempermudah warga
Jakarta Timur yang ingin nikmati jaringan internet cepat indihome.
Dengan memakai Tehnologi Fiber Optik, kami tawarkan sejumlah pelayanan paket internet seperti
Singgel Play, Dual Play dan Triple Play. Tidak hanya itu kami pun tawarkan beberapa Add On Favorit buat anda cicipi sama keluarga.
 
By: recomended
On: 09/13/2021 05:04:17
Indihome Jakarta Timur saat ini ada dengan pelayanan pasang jaringan Indihome lewat cara online, anda tak perlu hadir ke kantor indihome buat
lakukan register penempatan indihome. Ini adalah wujud service digital paling
depan dari Indihome Jakarta Timur buat meringankan warga Jakarta Timur yang pengin nikmati jaringan internet cepat indihome.

Dengan gunakan Tehnologi Fiber Optik, kami menjajakan beberapa pelayanan paket internet seperti
Singgel Play, Dual Play juga Triple Play. Terkecuali
itu kami menjajakan sejumlah Add On Teratas buat anda rasakan sama keluarga.
 
By: Press Release
On: 09/15/2021 17:51:13
Touche. Sound arguments. Keep up the amazing effort.
 
By: ????
On: 09/21/2021 10:14:36
I have read a few excellent stuff here. Definitely price
bookmarking for revisiting. I wonder how much attempt you set to make this type of excellent informative website.
 
By: https://www.bonanza.com
On: 09/25/2021 07:19:20
I'm gone to say to my little brother, that he should also pay a quick visit this web site on regular
basis to obtain updated from most up-to-date information.
 
By: game servers
On: 09/26/2021 09:02:26
Thanks for the unique tips provided on this site.
I have realized that many insurance companies offer buyers
generous discounts if tthey decide to insure a few cars with them.
A significant amount of households possess several automobiles these days, pecially those with old teenage kids still living at home,
and also the savings for policies can soon begin. So it
pays to look for a bargain.
 
By: clashofcryptos.trade
On: 10/05/2021 20:13:58
Useful info. Lucky me I found your website unintentionally, and I am stunned why this accident did not took place earlier!

I bookmarked it.
 
By: www.spreaker.com
On: 10/06/2021 13:49:38
I don't even know the way I stopped up here, but I assumed this
post was good. I don't recognise who you are however certainly you're going to a well-known blogger in case you are not already.
Cheers!
 
By: Ryan
On: 10/06/2021 20:06:03
I have been absent for some time, but now I remember why I used
to love this site. Thanks, I'll try and check back more often. How frequently you
update your site?
 
By: Teresita
On: 10/07/2021 08:19:11
Keep functioning ,great job!
 
By: Chineese betting software poker casino sports and live dealer
On: 10/07/2021 14:44:55
Hi! I just wanted to ask if you ever have any problems with hackers?
My last blog (wordpress) was hacked and I ended up losing many months of hard work due to no backup.
Do you have any solutions to stop hackers?
 
By: anuluj-dlugi.org
On: 10/10/2021 19:10:15
Write more, thats all I have to say. Literally, it seems as though you relied on the video to make your point.
You definitely know what youre talking about, why waste your intelligence on just posting videos to your site when you could be giving us something enlightening to read? http://anuluj-dlugi.org/upadlosc-konsumencka-porzewnica.php
 
By: olejki cbd bio
On: 10/15/2021 21:42:24
Hey there this is kind of of off topic but I was wanting to know if blogs use WYSIWYG editors or if you have to manually code with HTML.
I'm starting a blog soon but have no coding experience so I
wanted to get guidance from someone with experience.
Any help would be greatly appreciated!

Leave a comment

Please complete the form below to submit a comment on this article. A valid email address is required to submit a comment though it will not be displayed on the site.

HTML has been disabled but if you wish to add any hyperlinks or text formatting you can use any of the following codes: [B]bold text[/B], [I]italic text[/I], [U]underlined text[/U], [S]strike through text[/S], [URL]http://www.yourlink.com[/URL], [URL=http//www.yourlink.com]your text[/URL]

Archive

Contributors