What’s a patient visit worth?

  | October 14, 2016

Healthcare is a difficult business.

This is true at high strategic levels, due to shifts in payment models and the challenges of provider burnout, but it's also true at the most tactical level. Asking a simple question like "How much do we get paid for our services?" can easily lead to an hour-long explanation of CPT codes and "allowables."

And while these concepts are critical when a medical organization dives deep into revenue cycle issues, sometimes it's easier to just have a rule of thumb. A recent analysis of more than 136 million appointments, conducted across the athenahealth network in 2015, reveals a number that's surprising in its simplicity: An appointment is worth about $100.

The histogram above, which shows the average appointment value across practices on the athenahealth network, also highlights how much the value of a visit can vary. Depending on specialty and payer mix, some practices make much more than $100 per appointment, and several make much less.

Still, a ballpark number could be invaluable for considering the impact of various scenarios. Imagine a practice that loses 20 appointments per month because of patient cancellations and no shows. It's easy to assume that this represents about $2,000 of missed revenue — and that a high-tech solution that fills even five percent of those slots could be worthwhile.

At the very least, given what we know about what makes patients show up, it's probably worthwhile to invest in a good text-messaging plan.

Matthew Ritter is a data scientist with athenahealth's More Disruption Please program.

What’s a patient visit worth?