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ACC- Duke Heart Failure Program




Question;Duke Heart Failure ProgramHelpful HintsGeneral Observations? Inpatient hospital revenues decrease by approximately $7000 (DRG 127) for each CHF patient not admitted to the hospital.? Duke?s salaried cardiologists would only be minimally impacted by a move from inpatient to outpatient care.? CHF patients are relatively low margin patients at Duke (compared to say transplant patients).? Duke?s CHF clinic can allow it to substitute high margin for low margin patients.Specific Revenue ConsiderationsRevenue Loss Inpatient: 600 patients x reduction in admission rate x DRG reimbursementRevenue Loss: PhysicianAdmissions Decline: 600 patients x reduction in admissions rate x ($234+ $73x4)ALOS Decline: 1.21 admits per year x 600 x $73 x 1.6 (ALOS reduction)Revenue Increase: Physician (Hospital revenue increase due to increase clinic visits)600 patients x (12.9 ? 7.8) clinic visits per year = 3,060 extra visits (? NP and ? MD)(3/4 x 3060 x 0.85 x $100) + (? x 3060 x $100) =Specific Cost ConsiderationsHospital cost decline due to decline in admissions:600 patients x (1.86 ? 1.21) admits per year x $ 3800 per admitHospital cost decline due to decline in ALOS (use estimated cost of $500 per day):1.21 admits per year x 600 x $500 x 1.6 reduction in ALOS =Increase in hospital clinic costs:2.5NP FTE x $80K =Start-up costs: $125KWeek 5 Assignment 2: Case Write-Up: The Duke Heart Failure ProgramDue: Day 7Value: 100 pointsRead: Dartmouth-Hitchcock Medical Center: Spine CareRead: Duke Heart Failure Program: 604033-HCB-ENG.Answer the following questions only and show all your work (two pages maximum):1. How much money is Duke University Health System losing?2. What are the financial results of the CHF disease management program?Hint: Examine revenue and cost impacts for the hospital (inpatient and outpatient) and physicians' perspective.3. What are the pros and cons of a CHF disease management program like the one at Duke from the perspective of payers, providers, employers, patients, and a private carve-out?


Paper#43004 | Written in 18-Jul-2015

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