Cardiac CT Angiography (Coursework Sample)

CARDIAC CT ANGIOGRAPHY
Author’s Name
Institutional Affiliation
Cardiac CT Angiography, a tool for Cardiac Stress Testing
Coverage of cardiac CT angiography (CCTA) is a possible competitive diagnostic tool which could affect volumes of cardiac stress testing. Cardiac stress test are performed to assess the ability of blood flow or to measure the ability of the heart towards responding to external stress in a controlled environment. It is used to evaluate the presence of influences of emotional stresses which may lead to heart attacks.
Due to technological advancements, Cardiac CT angiography has been developed and remained appropriate t for cardiac stress testing. It is a non-invasive imaging technology that has the ability of providing pictures with details of organs and tissues within a patient’s body. It main focus is the heart and its surrounding vessels. The images it provides are used by physicians to help in the diagnosis of heart diseases and to provide an estimate of the likelihood of future heart attack. Cardiac CT angiography assists physicians in the treatment of heart diseases and determines the effectiveness of the current treatments. I addition, it may prevent the need for more invasive diagnosis (Hollander JE et al, 2007)
This study is based upon financial implications of adding an in-office nuclear cardiac stress lab to cardiology practice. It encompasses all aspects of healthcare finance including calculating revenue for procedures, estimating payer mix, actual reimbursement, bad debts, determination of capital and operating expenditures, contribution margin per producer, as well as, break-even volume for the venture. It encompasses compliance issues such as the coverage requirements and the stark physician self-referral laws relevant to the practice.
In planning for CCTA, there are many variations in policies making it difficult to predict the reimbursement level it may require. It is important to know the payment rates, even though some carriers have made their applicable rates in publications (Meijboom et al, 2008). With the current predictions that Medicare payments are likely to increase, more facilities will be required and the cost will continue to rise. Therefore, to limit the overall expenditures, local rates must change over time.
Most group physicians are for profit making, hence are subjected to tax. In the income tax, there should be a 33% of federal income tax rate and a 5% state income tax rate and a 2% local income tax rate. On the revenue tab of the project spread sheet, there should be the payer mix, payment terms, bad debt estimates which are necessary in the calculation of the gross revenues. The payer section includes; Medicare, Medicaid, BlueCross/Blue Shield, Aetna, Cigna, United Healthcare, Other commercial, Workers Comp, Self pay, and Charity care. The expenses will include staffing patterns and costs.
The capital expenditure will identify the dual headed nuclear camera, hot lab renovations, some additional plumbing, electrical and data cabling, treadmill and exam table, computer equipments and structural innovations. The expenses will include operating expenses as fixed, variable or semi variable by illustrating the appropriate type of expenses in the expense grid.
The staff type are included on the expenses tab of the project spread sheet to assist in the calculation of the staffing pattern and costs bases on the assumption that FTE counts will be calculated later after the estimation of the estimates. Staff will include’ physicians, registered nurses, respiratory technician, receptionist, nuclear medical technician, insurance verifier, biller, and collector.
There are additional operating costs based upon cost estimates of routine medical supplies, radiopharmaceuticals, nuclear license, radiation safety consultant, radiation exposure monitors, first year marketing expenses, one time clinician education, equipment insurance coverage, liability insurance coverage, and patient education materials (Hoffmann et al, 2005).
The break-even point is obtained when the cost of expenses and revenue are equal, and there is no net gain or loss making one to be broken even. In this case, there is no profit or loss made although the trend shows that opportunity costs have been paid and the capital received the risk adjusted and an expected return. The break point tool is a good management tool because it helps in the provision of a dynamic view of costs, sales, costs and profits. Having a better understanding of break even is that it expresses break-even sales as a percentage of exact sales as a percentage of the actual sales. The assumption to be made in the break-even point analysis is that average variable costs should be constant per unit of output in the range of likely quantities of sales. Furthermore, it assumes that the service provided is equal to that sold hence having no substantial change.
A high false-positive rate has serious implications causing unnecessary and risky procedures that could increase healthcare costs. Since the current healthcare expenditure exceeds the gross national product, the questions might arise concerning the introduction of the new technology (Hoffmann et al, 2005).
Clients will eagerly structure arrangements and transactions to comply with the Stark law. However, Stark do permit physicians from referring healthcare beneficiaries to entities that they do not have direct or indirect financial relations with DHS. DHS encompass clinical laboratories, physical therapies, radiology and CT scans among others. He...