ABSTRACT
Objective
To quantify downstream healthcare utilization and revenue associated with a self-pay
bi-parametric prostate MRI (bpMRI) program.
Methods
Medical records of 592 patients who underwent bpMRI between August 2017 and March
2020 were examined for follow-up clinical activities. These include prostate biopsy,
radical prostatectomy, external beam radiation therapy, brachytherapy, androgen deprivation
therapy, CT Chest, Abdomen and Pelvis, PET/CT, MRI Pelvis, and Nuclear Medicine Bone
Scans. The charges for each clinical activity were derived from the Medicare Physician
Fee Schedule to conservatively estimate revenues. This patient population was further
divided into four groups: Group A, patients who demonstrated an MRI lesion and underwent
prostatectomy; Group B, patients who did not demonstrate lesion but underwent prostatectomy;
Group C, patients who demonstrated lesion but did not undergo prostatectomy; and Group
D, patients who neither demonstrated lesion nor underwent prostatectomy. Revenues
for each group were categorized by Urology, Radiation Oncology and Radiology subspecialties.
Results
Conservative estimates yielded $520 of downstream revenue per patient who underwent
bpMRI. Group A patients yielded 47% of total revenue ($1974 per patient). Group B
patients, the smallest group, yielded $1828 per patient. Group C patients made up
the largest group and grossed $398 per patient. Group D demonstrated the lowest per
patient revenue of $179. Groups A and B yielded most relative revenue for Urology.
Group C yielded most relative revenue for Radiation Oncology, and Group D yielded
most relative revenue for Radiology.
Conclusion
A self-pay bpMRI program has the potential to improve patient access to prostate cancer
screening while remaining financial sustainable.
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Article info
Publication history
Published online: October 01, 2022
Accepted:
September 25,
2022
Received:
April 18,
2022
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
The author(s) declare no conflict of interest.
Identification
Copyright
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