Sat., 10/10/09 Basic Sci./Injury Prevent./Spine, Paper #76, 11:47 am OTA-2009
Financial Impact of a Dedicated Orthopaedic Traumatologist on a Private Group Practice
Peter L. Althausen, MD, MBA (7-Smith &Nephew, Synthes); Lisa Davis, MBA (n);
Eric Boyden, MD (n);
Timothy J. Omara, MD (7-Fellowship Support from Synthes, Smith &Nephew);
Timothy J. Bray, MD (4, 7-AO, Synthes);
Reno Orthopaedic Clinic, Reno, Nevada, USA
Purpose: Over the past several years, many different practice models for orthopaedic trauma systems have been proposed. At our institution, we have a trauma system staffed by private practice physicians. In 2005, our orthopaedic group hired a hospital-based orthopaedic traumatologist. This model has proved to be very successful for the traumatologist and group subspecialists as well. The purpose of the study was to evaluate the financial impact of the addition of a dedicated orthopaedic traumatologist to a large private group practice working at a Level 2 community-based trauma system.
Methods: Office billing and financial data were analyzed for the 12 months prior to the addition of the orthopaedic traumatologist and for a 2-year period following the hiring. Outcomes such as payor mix, collection rates, time to breakeven, days off, call days, evenings worked, durable medical equipment, radiology, and casting reimbursement were analyzed. The effect on existing elective clinical practices and numbers of elective surgeries were also recorded.
Results: The addition of a dedicated traumatologist was financially beneficial for the group practice. Existing elective practices increased 13% in charges and 23% in collections despite partners taking more vacation days and 14% less call. This was due in part to increased nontrauma referrals, full clinics, and uninterrupted elective operating room schedules. Over a 2-year period, elective arthroplasty cases increased 13.1%, elective arthroscopy cases increased 35.4%, and total patient office visits increased 18.8%. The payor mix for trauma patients was worse than the elective group practice profile; however, this was offset by decreased overhead requirements. Collections rates for the trauma partner in evaluation and management, surgery, casting, durable medical equipment, and radiology improved after the first year to become nearly equal to other clinic specialized practices. The cost of hiring a new trauma partner is substantial but recouped after 6 months.
Conclusions: A dedicated orthopaedic traumatologist can be financially beneficial to a group practice and to the traumatologist given the appropriate case volume, payor mix, hospital support for indigent care, and a relative value unit–based payment system.
• The FDA has not cleared this drug and/or medical device for the use described in this presentation (i.e., the drug or medical device is being discussed for an “off label” use). ◆FDA information not available at time of printing. Δ OTA Grant