Niagara Memorial is exploring a new contract with EDSI to staff their ED with Board certified providers. The Hospital would continue to bill and collect the technical component and EDSI would bill and collect the professional component for services in the ED. The hospital believes the move will give them coverage stability and a competitive edge in the community. The contract guarantees EDSI will cover its total cost with the hospital paying EDSI a fixed payment of $20,000 per month, plus any shortfall on their collections.(EDSI defines a loss as any amount of patient collections plus the fixed payment from the hospital that is less than their $3,444,500 of labor & non-labor cost)The Average EDSI physician charge is $400 per visit and all payers except the Uninsured pay a fixed fee shown below. Given the anticipate payer mix (below), what annual ED volume is needed to have the hospital avoid paying any additional money beyond the $20k per month?

 

Transcribed Image Text:

Payer Mix: Medicare Medicaid BC/BS UHC Uninsured % of Q 40% 15% 30% 10% 5% Avg Pro- Fee Rate $200 $100 $300 $310 $100 Fixed Fee Fixed Fee Fixed Fee Fixed Fee % Charge Avg Patient Payment Volume Revenue Payer Mix: Medicare Medicaid BC/BS UHC Uninsured % of Q 40% 15% 30% 10% 5% Avg Pro- Fee Rate $200 $100 $300 $310 $100 Fixed Fee Fixed Fee Fixed Fee Fixed Fee % Charge Avg Patient Payment Volume Revenue

Answer rating: 100% (QA)

For the hospital to avoid paying any additional money beyond the 20k per month EDSI must collect at ... View the full answer