Fianace Of HealthCare
glahai
project_spreadsheet_unit_9.xlkPRO FORMA INC STMT
| PRO FORMA INCOME STATEMENT | |
| REVENUES: | |
| Gross revenue | $ 3,000,000 |
| Less contractual allowances | $ (941,223) |
| Net patient revenue | $ 2,058,777 |
| EXPENSES: | |
| Salaries | $ 388,080 |
| Benefits | $ 93,139 |
| Medical supplies | $ 36,000 |
| Radiopharmaceuticals | $ 456,000 |
| Nuclear license | $ 425 |
| Radiation safety consultant | $ 3,500 |
| Radiation exposure monitoring | $ 13,200 |
| First-year marketing expense | $ 20,000 |
| Clinician education (one-time) | $ 40,000 |
| Equipment insurance coverage | $ 800 |
| Liability insurance coverage | $ 24,000 |
| Patient education materials | $ 800 |
| Interest expense | $ 100,000 |
| Depreciation expense | $ 127,000 |
| Bad debt expense | $ 149,363 |
| Total Expenses | $ 1,452,307 |
| Net Income Before Taxes | $ 606,470 |
| INCOME TAXES: | |
| Federal | $ 200,135 |
| State | $ 30,323 |
| Local | $ 12,129 |
| Total Taxes | $ 242,588 |
| Net Income After Taxes | $ 363,882 |
CONT MGN and BREAK-EVEN
| PRO FORMA INCOME STATEMENT | CONTRIBUTION MARGIN | |||
| BREAK-EVEN ANALYSIS | ||||
| VOLUME | 2,400 | |||
| REVENUES: | PER EXAM | TYPE OF EXP | ||
| Gross revenue | $ 3,000,000 | |||
| Less contractual allowances | $ (941,223) | |||
| Net patient revenue | $ 2,058,777 | $ 857.82 | Net patient revenue per exam | |
| VARIABLE EXPENSES: | ||||
| Salaries | $ 388,080 | $ 161.70 | variable | |
| Benefits | $ 93,139 | $ 38.81 | variable | |
| Medical supplies | $ 36,000 | $ 15.00 | variable | |
| Radiopharmaceuticals | $ 456,000 | $ 190.00 | variable | |
| Patient education materials | $ 800 | $ 0.33 | semi-variable | |
| Bad debt expense | $ 149,363 | $ 62.23 | ||
| Total Variable Expenses | $ 1,123,382 | $ 468.08 | Total Variable Expense per exam | |
| Contribution Margin | $ 935,395 | $ 389.75 | Contribution Margin per exam | |
| FIXED EXPENSES: | ||||
| Nuclear license | $ 425 | fixed | ||
| Radiation safety consultant | $ 3,500 | fixed | ||
| Radiation exposure monitoring | $ 13,200 | semi-variable | ||
| First-year marketing expense | $ 20,000 | fixed | ||
| Clinician education (one-time) | $ 40,000 | fixed | ||
| Equipment insurance coverage | $ 800 | fixed | ||
| Liability insurance coverage | $ 24,000 | semi-variable | ||
| Interest expense | $ 100,000 | fixed | ||
| Depreciation expense | $ 127,000 | fixed | ||
| Total Fixed Expenses | $ 328,925 | $ 328,925 | Total Fixed Expenses | |
| $ 389.75 | Contribution Margin per exam | |||
| 844 | BREAK-EVEN POINT | |||
| INCOME TAXES: | ||||
| Federal | $ 200,135 | |||
| State | $ 30,323 | |||
| Local | $ 12,129 | |||
| Total Taxes | $ 242,588 | |||
| Net Income After Taxes | $ 363,882 |
INCOME TAX
| INCOME TAXES: | RATES | AMOUNT |
| Federal | 33% | $ 200,135 |
| State | 5% | $ 30,323 |
| Local | 2% | $ 12,129 |
| Total taxes | 40% | $ 242,588 |
REVENUE
| PAYOR | % OF PATIENTS | % OF MPFS | BAD DEBT % | |||
| Medicare | 51% | 100% | 5% | |||
| Medicaid | 12% | 40% | 3% | |||
| Blue Cross/Blue Shield | 16% | 85% | 4% | |||
| Aetna | 6% | 80% | 6% | |||
| Cigna | 4% | 82% | 4% | |||
| United Healthcare | 5% | 70% | 8% | |||
| Other commercial | 2% | 75% | 3% | |||
| Workers' Comp | 1% | 60% | 7% | |||
| Self pay | 2% | Gross charge | 40% | |||
| Charity care | 1% | Gross charge | 100% | |||
| DESCRIPTION | CPT CODE | BALTO MD RATE | ||||
| Radionuclide | various | $ 265.00 | estimate per patient | |||
| Myocardial perfusion imaging; tomographic (SPECT), multiple studies (including attenuation correction when performed), at rest and/or stress (exercise and/or pharmacologic), and redistribution and/or rest injection, with or without quantification | 78465 | $ 511.08 | Use participating, non-facility price (with no modifiers) | |||
| Myocardial perfusion study with wall motion, qualitative or quantititative study (use in conjunction with 78460, 78461, 78464, 78465) | 78478 | $ 62.22 | ||||
| Myocardial perfusion study with ejection fraction (use in conjunction with 78460, 78461, 78464, 78465) | 78480 | $ 52.25 | ||||
| Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with physician supervision, with interpretation and report | 93015 | $ 96.84 | ||||
| TOTAL MEDICARE FEE | $ 987.39 | |||||
| GROSS CHARGE PER TEST | $ 1,250.00 | |||||
| % OF PATIENTS NEEDING STRESS TEST | ||||||
| PHYSICIAN CASELOAD | LOW | MEDIUM | HIGH | |||
| 2,000 | 5% | 10% | 20% | |||
| 2,500 | 5% | 10% | 20% | |||
| 3,000 | 5% | 10% | 20% | |||
| 3,500 | 5% | 10% | 20% | |||
| TOTAL ANNUAL TEST VOLUME | ||||||
| Physician caseload | 3,000 | |||||
| # of cardiologists | 8 | |||||
| % of patients needing stress testing | 10% | |||||
| Annual anticipated test volume | 2,400 | |||||
| PAYOR | VOLUME | GROSS REVENUE | NET FEE PER TEST | CONTRACTUAL ALLOWANCE | NET REVENUE | BAD DEBT EXPENSE |
| Medicare | 1,224 | $ 1,530,000 | $ 987.39 | $ 321,435 | $ 1,208,565 | $ 60,428 |
| Medicaid | 288 | $ 360,000 | $ 394.96 | $ 246,253 | $ 113,747 | $ 3,412 |
| Blue Cross/Blue Shield | 384 | $ 480,000 | $ 839.28 | $ 157,716 | $ 322,284 | $ 12,891 |
| Aetna | 144 | $ 180,000 | $ 789.91 | $ 66,253 | $ 113,747 | $ 6,825 |
| Cigna | 96 | $ 120,000 | $ 809.66 | $ 42,273 | $ 77,727 | $ 3,109 |
| United Healthcare | 120 | $ 150,000 | $ 691.17 | $ 67,059 | $ 82,941 | $ 6,635 |
| Other commercial | 48 | $ 60,000 | $ 740.54 | $ 24,454 | $ 35,546 | $ 1,066 |
| Workers' Comp | 24 | $ 30,000 | $ 592.43 | $ 15,782 | $ 14,218 | $ 995 |
| Self pay | 48 | $ 60,000 | $ 1,250.00 | $ - 0 | $ 60,000 | $ 24,000 |
| Charity care | 24 | $ 30,000 | $ 1,250.00 | $ - 0 | $ 30,000 | $ 30,000 |
| TOTALS | 2,400 | $ 3,000,000 | $ 941,223 | $ 2,058,777 | $ 149,363 |
Shana K Wolfe:
2009 fee schedule; does not exist for 2010
Shana K Wolfe:
2009 fee schedules; does not exist for 2010
Shana K Wolfe:
2009 fee schedule; does not exist for 2010
Shana K Wolfe:
2010 fee schedule
EXPENSES
| PROJECTED VOLUME: | 2,400 | ||||
| STAFFING: | AVG HR RATE | HOURS/TEST | TOTAL STAFF COUNT | COST | FTE |
| Physician | $ 160.00 | 0.50 | 8 | $ 192,000 | 0.58 |
| Registered Nurse | $ 28.00 | 1.00 | 10 | $ 67,200 | 1.15 |
| Respiratory Technician | $ 24.50 | 0.50 | 6 | $ 29,400 | 0.58 |
| Nuclear Medicine Technician | $ 32.00 | 1.00 | 2 | $ 76,800 | 1.15 |
| Receptionist | $ 9.50 | 0.20 | 6 | $ 4,560 | 0.23 |
| Insurance verifier | $ 13.50 | 0.30 | 4 | $ 9,720 | 0.35 |
| Biller | $ 11.00 | 0.10 | 4 | $ 2,640 | 0.12 |
| Collector | $ 12.00 | 0.20 | 4 | $ 5,760 | 0.23 |
| TOTAL | 44 | $ 388,080 | 4.38 | ||
| Benefits as % of salary cost | 24% | $ 93,139 | |||
| OPERATING EXPENSES: | COST | UNITS | TYPE OF EXP | ||
| Salaries | variable | $ 388,080 | |||
| Benefits | variable | $ 93,139 | |||
| Routine medical supplies | $ 15 | per test | variable | $ 36,000 | |
| Radiopharmaceuticals | $ 190 | per test | variable | $ 456,000 | |
| Nuclear license | $ 425 | per year | fixed | $ 425 | |
| Radiation safety consultant | $ 3,500 | per year | fixed | $ 3,500 | |
| Radiation exposure monitors | $ 300 | per employee per year | semi-variable | $ 13,200 | |
| First-year marketing expense | $ 20,000 | per year | fixed | $ 20,000 | |
| Clinician education (one-time) | $ 40,000 | per year | fixed | $ 40,000 | |
| Equipment insurance coverage | $ 800 | per year | fixed | $ 800 | |
| Liability insurance coverage | $ 3,000 | per year per physician | semi-variable | $ 24,000 | |
| Patient education materials | $ 200 | for 600 pieces | semi-variable | $ 800 | |
| Interest expense | fixed | $ 100,000 | |||
| Depreciation | fixed | $ 127,000 | |||
| TOTAL EXPENSES (not including bad debts) | $ 1,302,944 | ||||
| CAPITAL EXPENDITURES: | COST | USEFUL LIFE (YRS) | DEPRECIATION | ||
| Dual-headed nuclear camera | $ 560,000 | 8 | $ 70,000 | ||
| "Hot lab" renovations | $ 220,000 | 12 | $ 18,333 | ||
| Additional plumbing | $ 40,000 | 15 | $ 2,667 | ||
| Electrical & data cabling | $ 30,000 | 15 | $ 2,000 | ||
| Treadmill, exam table, etc. | $ 50,000 | 5 | $ 10,000 | ||
| Computer equipment | $ 20,000 | 5 | $ 4,000 | ||
| Structural renovations | $ 600,000 | 30 | $ 20,000 | ||
| $ 1,520,000 | $ 127,000 | ||||
| FINANCING: | |||||
| Borrow | $ 1,250,000 | ||||
| Interest rate | 8% | ||||
| Term in years | 20 |
