Latest / Medsolve Dynamics / The Hospital Math Says Build. The Physician Math Says Do Not. That Gap Is The wRVU Trap.
Transcript
- Yoel Bakas: I have tried to spend the last few weeks not focused on what can't be done about the reimbursement changes, but rather focused on what we can do about them. If your Q2 numbers off, likely, like many departments, you are trying to understand ⁓ the revenue can come from to make up the difference. There is an answer that points inside the building to leveraging what you already have. Micro, and ACR have been making the case for some time that radioligand therapy belongs in oncology. Of course, in close collaboration with the multifunctional team, including Nuc Med and MedOnc The credential map is the argument. Radiation safety officer authority. Dosimetry understanding and coverage. Physics, space. and the authorized user pathway. The licenses, the badges, the staff trained to deal with liquid radiation therapy already exist inside your department. Not somewhere new. The operating math is usually clean. A Peer review paper accepted By practical radiation oncology out of Jefferson Three weeks ago. Puts 340 B eligible hospital margins At roughly one hundred and one thousand dollars per pluvicto treatment. Over a full six dose course. Thirty one percent discount. A fifty one thousand dollar dose. Six doses repeated per patient. So the operating math says move. What I have watched in programs at stall is that move is harder than the math. The same paper names the reason. A twenty fraction external beam radiotherapy course generates Roughly forty-seven RVUs for the RadOnc. A full Pluvicto course generates roughly twenty. Twenty point six to be precise. A RadOnc on a pure RVU comp model takes a 20 RVU, 26 RVU haircut every time a patient is treated. That on a treatment that puts hundreds of thousands of dollars of margin on the hospital's ledger. Hospital's math says build it. The physician math says do not. And so the decision goes somewhere else in the building. The operator move sits beneath that. Before the Theronostic service line gets approved. The comp model for that physician gets renegotiated. The 340B margins in the hospital means the hospital has room to do that. Like in many negotiations, it's not about not getting it. It's about not asking. The credential map is already in your department. Comp model is the way to enable it.