$1.$ Use the accompanying Excel worksheet to calculate the costs and profits of the three different DPOS office visits using:

a$.$ RCC method

b$.$ TDABC method

$2.$ Suppose Dr$.$ Meara anticipates that the following year, the DPOS office will have $5,400$ Plagiocephally visits, $2,000$ Neoplasm visits, and $800$ Cranyosynostosis visits.

a$.$ How many staff, of each type, will he need to handle this volume and mix of patient visits?

b$.$ What is the total cost of this staffing level?

c$.$ What is the quantity and cost of the unused capacity with your staffing recommendation?

$3.$ Suppose DPOS implements a process change by using an RN to perform some of the surgeon$’$s work during a plagiocephaly exam. The surgeon$’$s time decreases from $18$ to $10$ minutes, while the RN$’$s increases from $23$ to $39$ minutes. How will this change the staffing levels and cost for office visits at DPOS?

Note: answer the questions by using the excel sheet, and provide actual numbers.

Thank You

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DPOS Assignment Worksheet Resource Weeks per year Less: Vacation & Holidays Less: Training and Leave Surgeon ASR RN CA 52 52 52 52 6 4 4 4 2 2 2 2 Available weeks per year 44 46 46 46 Hours per day 10 00 8 8 Less: Breaks, training, meetings 1.2 1.5 1.5 1.5 Available hours 8.8 6.5 6.5 6.5 Less: Estimate of Research & Education time (%) 25% 0% 0% 0% Clinical Hours per day 6.6 6.5 6.5 6.5 Cllinical minutes available per day Clinical minutes available per year Annual Cost per person Capacity cost rate ($ per minute) Personnel process times (minutes) Plagiocephaly Neoplasm skin excision Craniosynostosis $ 522,720 $89,700 $134,550 $ 71,760 18 8 22 55.5 40 10.5 328 23 5 20 5 23 10 Medical Diagnosis Cost per patient visit Surgeon ASR RN CA Total cost Charge Average reimbursement Plagiocephaly $ 350 Neoplasm skin excision $ $ 350 Craniosynostosis $ 350 Plastic Surgery Dept. Charges Costs Reimbursement RCC: Ratio of costs-to-charges Average DPOS reimbursement rate Capacity Question Plagiocephaly Neoplasm skin excision Craniosynostosis Number of personnel Minutes demanded Minutes supplied Unused capacity (minutes) Cost of unused capacity Percent capacity utilization $ 12,449,500 7,469,700 7,967,680 64% Surgeon ASR RN CA Annual Quantity 18 8 23 5 4,400 22 56 20 5 2,200 40 11 23 10 1,800 2.5 2 N Orthopedic Surgeon Plaster Cast Technician Ambulatory Service Representative 440,000 $ 73,160 $ 52,370 62,000 48,000 38,100 26,900 20,000 10,000 10,000 58,000 $ 693,000 $ 83,160 $ 62,370 Resource Costs Salary and Fringes $ Billing Support Malpractice Insurance Professional Expenses Administrative Support Departmental Administration Miscellaneous, other Total Available Time 1 Maximum, after weekends 261 261 261 Vacation, holidays, leave, etc 41 30 30 Available Days per year 220 231 231 Maximum hours per day 12.0 7.5 7.5 Less: research, teaching, and other 4.5 Less: breaks 1.50 1.50 Available hours per day 7.5 6.0 6.0 Available hours per year Available minutes per year 1,650 99,000 1,386 83.160 1,386 83,160 Cost per minute $ 7.00 $ 1.00 $ 0.75 Procedure Minutes Long leg cast application, cotton padding Long leg cast removal, cotton padding Long leg cast application, Gore-Tex padding Long leg cast removal, Gore-Tex padding 13.0 13.0 Petrie long leg cast application Petrie long leg cast removal 17.0 Clubfoot cast (hospital; initial visit) Clubfoot cast (hospital; replacement visit) 13.0 13.0 17.0 Clubfoot cast (hospital; final visit) 22.0 8.0 TDABC Profit RCC Cost RCC Profit $ 69 69 69 I Indirect Hospital Procedure Labor Direct Materials Indirect Supplies Total (Part of Direct Direct Costs) Costs Costs (Given for case purposes) Total Costs Average Charge Reimbursement Average Profit! Procedure Long leg cast, cotton padding 44.70 1.60 $ Long leg cast, Gore-Tex padding 156.10 1.60 57.40 122.01 523.00 $ 366.10 $ 584.00 $ 408.80 Petrie long leg cast 94.40 1.60 107.73 $ 181.00 $ 126.70 Clubfoot cast (initial visit) 10.40 1.60 15.66 Clubfoot cast (4x replacement visits) 10.40 1.60 18.36 Clubfoot cast (final visit) Clubfoot cast (6 total visits, incl. initial & final) Cast Room Data $ 4.32 $ - $ 52.00 $ 8.00 $ 93.42 $ 1,690.00 $ 1,183.00 Number of different club foot casts Indirect Supplies (cost per procedure, Alliance calculates only for billed events) $ 5 1.60 Indirect hospital costs are given using Alliance System's overhead factor of approxiamately 50% of total non-physician direct costs. DPOS Assignment Worksheet Resource Weeks per year Less: Vacation & Holidays Less: Training and Leave Surgeon ASR RN CA 52 52 52 52 6 4 4 4 2 2 2 2 Available weeks per year 44 46 46 46 Hours per day 10 00 8 8 Less: Breaks, training, meetings 1.2 1.5 1.5 1.5 Available hours 8.8 6.5 6.5 6.5 Less: Estimate of Research & Education time (%) 25% 0% 0% 0% Clinical Hours per day 6.6 6.5 6.5 6.5 Cllinical minutes available per day Clinical minutes available per year Annual Cost per person Capacity cost rate ($ per minute) Personnel process times (minutes) Plagiocephaly Neoplasm skin excision Craniosynostosis $ 522,720 $89,700 $134,550 $ 71,760 18 8 22 55.5 40 10.5 328 23 5 20 5 23 10 Medical Diagnosis Cost per patient visit Surgeon ASR RN CA Total cost Charge Average reimbursement Plagiocephaly $ 350 Neoplasm skin excision $ $ 350 Craniosynostosis $ 350 Plastic Surgery Dept. Charges Costs Reimbursement RCC: Ratio of costs-to-charges Average DPOS reimbursement rate Capacity Question Plagiocephaly Neoplasm skin excision Craniosynostosis Number of personnel Minutes demanded Minutes supplied Unused capacity (minutes) Cost of unused capacity Percent capacity utilization $ 12,449,500 7,469,700 7,967,680 64% Surgeon ASR RN CA Annual Quantity 18 8 23 5 4,400 22 56 20 5 2,200 40 11 23 10 1,800 2.5 2 N Orthopedic Surgeon Plaster Cast Technician Ambulatory Service Representative 440,000 $ 73,160 $ 52,370 62,000 48,000 38,100 26,900 20,000 10,000 10,000 58,000 $ 693,000 $ 83,160 $ 62,370 Resource Costs Salary and Fringes $ Billing Support Malpractice Insurance Professional Expenses Administrative Support Departmental Administration Miscellaneous, other Total Available Time 1 Maximum, after weekends 261 261 261 Vacation, holidays, leave, etc 41 30 30 Available Days per year 220 231 231 Maximum hours per day 12.0 7.5 7.5 Less: research, teaching, and other 4.5 Less: breaks 1.50 1.50 Available hours per day 7.5 6.0 6.0 Available hours per year Available minutes per year 1,650 99,000 1,386 83.160 1,386 83,160 Cost per minute $ 7.00 $ 1.00 $ 0.75 Procedure Minutes Long leg cast application, cotton padding Long leg cast removal, cotton padding Long leg cast application, Gore-Tex padding Long leg cast removal, Gore-Tex padding 13.0 13.0 Petrie long leg cast application Petrie long leg cast removal 17.0 Clubfoot cast (hospital; initial visit) Clubfoot cast (hospital; replacement visit) 13.0 13.0 17.0 Clubfoot cast (hospital; final visit) 22.0 8.0 TDABC Profit RCC Cost RCC Profit $ 69 69 69 I Indirect Hospital Procedure Labor Direct Materials Indirect Supplies Total (Part of Direct Direct Costs) Costs Costs (Given for case purposes) Total Costs Average Charge Reimbursement Average Profit! Procedure Long leg cast, cotton padding 44.70 1.60 $ Long leg cast, Gore-Tex padding 156.10 1.60 57.40 122.01 523.00 $ 366.10 $ 584.00 $ 408.80 Petrie long leg cast 94.40 1.60 107.73 $ 181.00 $ 126.70 Clubfoot cast (initial visit) 10.40 1.60 15.66 Clubfoot cast (4x replacement visits) 10.40 1.60 18.36 Clubfoot cast (final visit) Clubfoot cast (6 total visits, incl. initial & final) Cast Room Data $ 4.32 $ - $ 52.00 $ 8.00 $ 93.42 $ 1,690.00 $ 1,183.00 Number of different club foot casts Indirect Supplies (cost per procedure, Alliance calculates only for billed events) $ 5 1.60 Indirect hospital costs are given using Alliance System's overhead factor of approxiamately 50% of total non-physician direct costs.