Revenue/cost per patient

Steps involved in determining hours per patient day on a unit consist of:

  1. Identify staff in the clinic.
  2. Determine how many staff work each day. Add up the number of hours each direct care staff person works in a day. Multiply that number by the days providing services (5, 6, or 7).
  3. Using the number of patients seen on average in a day, calculate the hours per patient provided each day. Multiple by the number of days the clinic is open each week.
  4. Additional hours can be added for fixed or overhead expense to determine overall cost per patient. This can be separated by direct and indirect staff to determine the exact numbers (secretaries, managers, educators, staff meetings, etc.)


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  • Open six days a week
  • Numbers of patient visits per day = 25
  • The clinic is staffed with two RNs, two MAs, one NP and one MD
  • There is one clinic administrator
  • There is a half time billing clerk
  • Receptionist coverage is 8 am to 5pm with one hour closure for lunch

Total Hours per patient per day? _______________Per Week _______________

In analyzing the implications, calculate the following changes_

  • If you want to decrease hours per patient, what could you change?
  • What is the resulting hours per patient per day?
  • If want to change skill mix, what would you change?
  • What is the resulting hours per patient per day ?
  • How would you determine the ideal HPPD?
  • How did you arrive at this number?
  • If increasing cost, how would you justify for stakeholder buy in?


  • If decreasing cost, how do you justify for stakeholder buy in?

*Remember that you are responsible for both clinical and financial outcomes – why is the change you made important and how can it be justified?

For the attached spreadsheet, Revenue inst.712.xlsx, each individual will answer the following questions:

  • Which month had the best volume?
  • Which month had the best revenue
  • Which payer results in the best reimbursement?
  • In commercial payers decided to discount payment to 70% of charges, what would the financial impact be for the quarter?
  • What changes would you try and make to your marketing plan and your financial plan based on this exercise?


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