Medical Staff

Hospitalists pay for themselves at teaching hospitals

Hospitalist Leadership Connection, August 11, 2010

A hospitalist program can be cost-effective at public teaching hospitals, according to a new study, “Cost-effectiveness of a hospitalist service in a public teaching hospital,” published in the August issue of Academic Medicine.

The authors of the article implemented an academic hospitalist team, focusing on low-risk chest pain patients. Before implementing the program, the number of inpatients had exceeded the hospital’s teaching service capabilities; the majority of revenue was coming from per diem reimbursement from California’s Medicaid program, Medi-Cal.

After implementation, the Medi-Cal payments were $2.31 million higher than before implementation. Length of stay for low-risk chest pain admissions decreased from 2.48 to 1.92 days. Average reimbursement per inpatient day increased $955, up from $787 the previous year.

“By reducing payment denials and increasing the inpatient census, hospitalists were able to more than offset their compensation with a substantial increase in revenue under per diem reimbursement, which adds a new dimension to prior reports of cost-effectiveness of hospitalist services in diagnosis-based, capitated, or fee-for-service reimbursement systems,” the study states. “Hospitalists are a cost-effective solution to the problem of increasing inpatient workloads at public teaching hospitals.”

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