Miscellaneous factors. Your facility's hours of operation matter.
Do you allow add-ons, weekend cases or late cases? Do anesthe-
sia providers have any say when it comes to room utilization and min-
imum cases per room? If, for example, a 3-OR ASC expects to always
have 3 providers available for surgeon convenience, that's expensive.
You likely won't find providers willing to work only a couple of hours
a day with no guaranteed minimum.
$300,800 per year
Let's say a CRNA does nothing but basic hernia repairs (or something
similar), and that each takes an hour. We'll value each at 10 units (6
base + 4 time). Since Medicare pays about $22 per unit, each case
would generate about $220. Let's further assume a 30-minute turn-
around, and that our CRNA takes a 30-minute lunch and 2 15-minute
breaks. That leaves time for 5 cases per day, which would generate
$1,100 (5 x $220) daily.
What if we add some private insurers to the mix at, say, $40 a unit and
assume a payer mix that's 80% Medicare/Medicaid and 20% private?
Now we're looking at $1,280 per day (4 x $220) plus (1 x $400). If we
extrapolate over a full year, assuming 5 days a week and 5 vacation
weeks a year, that CRNA would handle 1,175 cases and generate
$300,800 (47 weeks at $6,400 per week). It's a relatively conservative
estimate, but there may be fewer cases, and the payer mix may be
worse. Plus, as noted, other factors can impact the bottom line, too,
such as non-revenue generating services and canceled cases.
OSM
Mr. MacKinnon (mmackinnon123@gmail.com) is a partner in a CRNA-
only practice in Show Low, Ariz. He lectures nationally on airway manage-
ment and the business of anesthesia.
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