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Introduction:The Virtual Diabetes Specialty Clinic (VDiSC) study demonstrated the feasibility of providing comprehensive diabetes care entirely virtually by combining virtual visits with continuous glucose monitoring support and remote patient monitoring (RPM). However, the financial sustainability of this model remains uncertain. Methods:We developed a financial model to estimate the variable costs and revenues of virtual diabetes care, using visit data from the 234 VDiSC participants with type 1 or type 2 diabetes. Data included virtual visits with certified diabetes care and education specialists (CDCES), endocrinologists, and behavioral health services (BHS). The model estimated care utilization, variable costs, reimbursement revenue, gross profit, and gross profit margin per member, per month (PMPM) for privately insured, publicly insured, and overall clinic populations (75% privately insured). We performed two-way sensitivity analyses on key parameters. Results:Gross profit and gross profit margin PMPM (95% confidence interval) were estimated at $−4 ($−14.00 to $5.68) and −4% (−3% to −6%) for publicly insured patients; $267.26 ($256.59-$277.93) and 73% (58%-88%) for privately insured patients; and $199.41 ($58.43-$340.39) and 67% (32%-102%) for the overall clinic. Profits were primarily driven by CDCES visits and RPM. Results were sensitive to insurance mix, cost-to-charge ratio, and commercial-to-Medicare price ratio. Conclusions:Virtual diabetes care can be financially viable, although profitability relies on privately insured patients. The analysis excluded fixed costs of clinic infrastructure, and securing reimbursement may be challenging in practice. The financial model is adaptable to various care settings and can serve as a planning tool for virtual diabetes clinics.
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Effects of Concurrency in Complex Service Organizations: Evidence from Electronic Health Records
We use Kremser and Blagoev’s [1] role-routine ecology to theorize about the effects of concurrency in complex service organizations, such as outpatient medical clinics. In a typical clinic, teams of specialized individuals serve multiple clients at the same time. There can be concurrency within a patient visit (a technician may be preparing for a procedure while the doctor talks to the patient) and concurrency between patient visits (multiple patients being treated in the clinic). Using data from electronic health records, we estimate the effects of concurrency within and between patient visits on the duration of patient visits in a set of dermatology clinics. As expected, we find that concurrency within patient visits is associated with reduced duration, while concurrency between visits is associated with increased duration. We discuss the implication of these findings for process mining and discovery of process models in organizations where process instances are not independent.
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- Award ID(s):
- 2120530
- PAR ID:
- 10436579
- Date Published:
- Journal Name:
- Business Process Management Workshops. BPM 2022. Lecture Notes in Business Information Processing
- Volume:
- 460
- Page Range / eLocation ID:
- 149–160
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Conference Paper:
- https://doi.org/10.1007/978-3-031-25383-6_12
