RE: LOV (Low Overhead Volume) vs. HOV (High Overhead Volume) numbers - VERY INTEREST

[Guest guest]

About the only sort potentially confusing comment I see is regarding your

malpractice cost. To tell new grads that you only pay $1230/year in

malpractice should include a big footnote that explains. Mine costs

$13,000/year & I'm only two years out of residency (no claims). I realize

yours is part time, but even that needs explained further. Also, many

carriers won't grant part time policies or else they are not much cheaper.

It also needs explained that the cost of claims made policies increase for

the first 3-5 years exponentially. Are you saying that your malpractice

premium will max out at $2460/year? That seems nearly impossible. If you

don't clearly explain that to residents in training they might not be making

an informed decision. That same thing sort of happened with Gordon's

original articles in FPM. He mentioned that his malpractice costs & costs

for Alteer were ridiculously low and that caused a flurry of questions

asking for clarification. Those cost numbers basically can't be reproduced

now, and new grads need to know both the good & the bad. They need to know

that duplicating this style of practice will be much more difficult in

certain locales & with different cost assumptions.

LOV (Low Overhead Volume) vs. HOV (High

Overhead Volume) numbers - VERY INTEREST

Hello all. I am preparing to give a grand rounds presentation in NY state

later next month

to inspire the latest grads in the LOV (Low Overhead Volume) model vs. the

HOV (High

Overhead Volume) model. I guess I LOVE the LOV model! The numbers

crunching I did

today really highlighted the differences in a visceral way for me.

Low Overhead Volume (LOV) vs. High Overhead Volume (HOV)

Ultralight Practice Assembly line medicine

Low Volume practices in the news --> Housecall MD, Boutique practices

my personal real life comparisons

OR... How I saved 26.5 K/month in overhead

2005-current 2000-2002

LOV (Low Overhead Volume) HOV (High Overhead Volume)

Self Employed Employee with partnership

potential

Part Time Full Time

3 half days/ week 4 full days/ week

$130 K/ yr $130 K/ yr (base 110K plus

bonus)

10 K / yr OH (overhead) 330K/ yr OH (overhead)

<1K mo OH 27.5 K mo OH

What does an ultralight overhead look like?

My LOV OH (excluding 3K start up expense) recurring expenses

in order of cost

rent @ 300/mo 3600/yr

Personal health insurance 2200/yr

(spouse, me)

malpractice 1st yr 1230 (at 50%)

Medical supplies 700/yr

Phone cell + land 700/yr

Office liability insurance 500/yr

Hospital/society Dues 600/yr

Office supplies 300/yr

9830

= 819/mo

Compare % OH (overhead) LOV & HOV models

My LOV Revenue 2500-3000/wk = 130K- 156K (call it 130K)

% OH/TOTrevenue 9830/130,000 =>> 7.6 % is overhead

HOV OH in practice 330K/yr or 27.5K/mo

so I brought in 460K/yr with 130K salary

% OH/TOT revenue 330K/460 K=>> 71.7% is overhead

(MGMA 60% average OH for HOV in 2002)

How many days will I have to work to pay my OH?

LOV part time to pay overhead at 10K/yr? < 1 month

3.3 weeks

@ 3 half days week

= 10 half days

making $1000 per 1/2 day

HOV full time to pay my portion of OH? 8.6 months

37.2 weeks

@ 4 full days/wk

= 148.8 full days

making $2218 per full day

How many patients seen per year to pay overhead ??

Pts/wk (at 25/wk) x 3.3 wks to pay part time OH LOV = 83 patients

@ $118/pt collected

Pts/wk (112/wk) x 37.2 wks to pay full time OH HOV = 4166 patients

@ $79.21/pt collected

Collection rate AR 30,60, 90 days?

LOV no cash collections/bad debt department -

all cash pts pay in full at time of service

insurance payments received 14-21 day average, no AR 60,90 accounts

HOV pts sent to collections, billing dept tracking unpaid

accounts

uninsured pts not accepted or cash pts with unpaid balances at visit

insurance payments with larger 30,60,90 ARs to track, denials to

follow

Lack of data on LOV in medical literature

Recruiters, MGMA, medical organizations give statistics based on HOV

practices

LOV practices were the norm 50 years ago, but most docs are not exposed to

LOV data in training, journals or elsewhere and are heavily marketed with

HOV

" opportunities "

So I am open for comments and most appreciative for your thoughts. This is

just the

financial portion of my presentation. I like it because it highlights the

differences in a

dramatic real life way. By the way the 130K/yr is extrapolated into the

first 12 months at

capacity at my " LOVe " practice. I reached capacity 2-3 montsh ago and the #s

have

supported my figures above since. The first 6-8 months were " start-up "

months and not

typical of the future numbers.

Thanks!

Pamela

Pamela Wible, MD

Family & Community Medicine, LLC

3575 st. #220

Eugene, OR 97405

roxywible@...

[Guest guest]

About the only sort potentially confusing comment I see is regarding your

malpractice cost. To tell new grads that you only pay $1230/year in

malpractice should include a big footnote that explains. Mine costs

$13,000/year & I'm only two years out of residency (no claims). I realize

yours is part time, but even that needs explained further. Also, many

carriers won't grant part time policies or else they are not much cheaper.

It also needs explained that the cost of claims made policies increase for

the first 3-5 years exponentially. Are you saying that your malpractice

premium will max out at $2460/year? That seems nearly impossible. If you

don't clearly explain that to residents in training they might not be making

an informed decision. That same thing sort of happened with Gordon's

original articles in FPM. He mentioned that his malpractice costs & costs

for Alteer were ridiculously low and that caused a flurry of questions

asking for clarification. Those cost numbers basically can't be reproduced

now, and new grads need to know both the good & the bad. They need to know

that duplicating this style of practice will be much more difficult in

certain locales & with different cost assumptions.

LOV (Low Overhead Volume) vs. HOV (High

Overhead Volume) numbers - VERY INTEREST

Hello all. I am preparing to give a grand rounds presentation in NY state

later next month

to inspire the latest grads in the LOV (Low Overhead Volume) model vs. the

HOV (High

Overhead Volume) model. I guess I LOVE the LOV model! The numbers

crunching I did

today really highlighted the differences in a visceral way for me.

Low Overhead Volume (LOV) vs. High Overhead Volume (HOV)

Ultralight Practice Assembly line medicine

Low Volume practices in the news --> Housecall MD, Boutique practices

my personal real life comparisons

OR... How I saved 26.5 K/month in overhead

2005-current 2000-2002

LOV (Low Overhead Volume) HOV (High Overhead Volume)

Self Employed Employee with partnership

potential

Part Time Full Time

3 half days/ week 4 full days/ week

$130 K/ yr $130 K/ yr (base 110K plus

bonus)

10 K / yr OH (overhead) 330K/ yr OH (overhead)

<1K mo OH 27.5 K mo OH

What does an ultralight overhead look like?

My LOV OH (excluding 3K start up expense) recurring expenses

in order of cost

rent @ 300/mo 3600/yr

Personal health insurance 2200/yr

(spouse, me)

malpractice 1st yr 1230 (at 50%)

Medical supplies 700/yr

Phone cell + land 700/yr

Office liability insurance 500/yr

Hospital/society Dues 600/yr

Office supplies 300/yr

9830

= 819/mo

Compare % OH (overhead) LOV & HOV models

My LOV Revenue 2500-3000/wk = 130K- 156K (call it 130K)

% OH/TOTrevenue 9830/130,000 =>> 7.6 % is overhead

HOV OH in practice 330K/yr or 27.5K/mo

so I brought in 460K/yr with 130K salary

% OH/TOT revenue 330K/460 K=>> 71.7% is overhead

(MGMA 60% average OH for HOV in 2002)

How many days will I have to work to pay my OH?

LOV part time to pay overhead at 10K/yr? < 1 month

3.3 weeks

@ 3 half days week

= 10 half days

making $1000 per 1/2 day

HOV full time to pay my portion of OH? 8.6 months

37.2 weeks

@ 4 full days/wk

= 148.8 full days

making $2218 per full day

How many patients seen per year to pay overhead ??

Pts/wk (at 25/wk) x 3.3 wks to pay part time OH LOV = 83 patients

@ $118/pt collected

Pts/wk (112/wk) x 37.2 wks to pay full time OH HOV = 4166 patients

@ $79.21/pt collected

Collection rate AR 30,60, 90 days?

LOV no cash collections/bad debt department -

all cash pts pay in full at time of service

insurance payments received 14-21 day average, no AR 60,90 accounts

HOV pts sent to collections, billing dept tracking unpaid

accounts

uninsured pts not accepted or cash pts with unpaid balances at visit

insurance payments with larger 30,60,90 ARs to track, denials to

follow

Lack of data on LOV in medical literature

Recruiters, MGMA, medical organizations give statistics based on HOV

practices

LOV practices were the norm 50 years ago, but most docs are not exposed to

LOV data in training, journals or elsewhere and are heavily marketed with

HOV

" opportunities "

So I am open for comments and most appreciative for your thoughts. This is

just the

financial portion of my presentation. I like it because it highlights the

differences in a

dramatic real life way. By the way the 130K/yr is extrapolated into the

first 12 months at

capacity at my " LOVe " practice. I reached capacity 2-3 montsh ago and the #s

have

supported my figures above since. The first 6-8 months were " start-up "

months and not

typical of the future numbers.

Thanks!

Pamela

Pamela Wible, MD

Family & Community Medicine, LLC

3575 st. #220

Eugene, OR 97405

roxywible@...

[Guest guest]

About the only sort potentially confusing comment I see is regarding your

malpractice cost. To tell new grads that you only pay $1230/year in

malpractice should include a big footnote that explains. Mine costs

$13,000/year & I'm only two years out of residency (no claims). I realize

yours is part time, but even that needs explained further. Also, many

carriers won't grant part time policies or else they are not much cheaper.

It also needs explained that the cost of claims made policies increase for

the first 3-5 years exponentially. Are you saying that your malpractice

premium will max out at $2460/year? That seems nearly impossible. If you

don't clearly explain that to residents in training they might not be making

an informed decision. That same thing sort of happened with Gordon's

original articles in FPM. He mentioned that his malpractice costs & costs

for Alteer were ridiculously low and that caused a flurry of questions

asking for clarification. Those cost numbers basically can't be reproduced

now, and new grads need to know both the good & the bad. They need to know

that duplicating this style of practice will be much more difficult in

certain locales & with different cost assumptions.

LOV (Low Overhead Volume) vs. HOV (High

Overhead Volume) numbers - VERY INTEREST

Hello all. I am preparing to give a grand rounds presentation in NY state

later next month

to inspire the latest grads in the LOV (Low Overhead Volume) model vs. the

HOV (High

Overhead Volume) model. I guess I LOVE the LOV model! The numbers

crunching I did

today really highlighted the differences in a visceral way for me.

Low Overhead Volume (LOV) vs. High Overhead Volume (HOV)

Ultralight Practice Assembly line medicine

Low Volume practices in the news --> Housecall MD, Boutique practices

my personal real life comparisons

OR... How I saved 26.5 K/month in overhead

2005-current 2000-2002

LOV (Low Overhead Volume) HOV (High Overhead Volume)

Self Employed Employee with partnership

potential

Part Time Full Time

3 half days/ week 4 full days/ week

$130 K/ yr $130 K/ yr (base 110K plus

bonus)

10 K / yr OH (overhead) 330K/ yr OH (overhead)

<1K mo OH 27.5 K mo OH

What does an ultralight overhead look like?

My LOV OH (excluding 3K start up expense) recurring expenses

in order of cost

rent @ 300/mo 3600/yr

Personal health insurance 2200/yr

(spouse, me)

malpractice 1st yr 1230 (at 50%)

Medical supplies 700/yr

Phone cell + land 700/yr

Office liability insurance 500/yr

Hospital/society Dues 600/yr

Office supplies 300/yr

9830

= 819/mo

Compare % OH (overhead) LOV & HOV models

My LOV Revenue 2500-3000/wk = 130K- 156K (call it 130K)

% OH/TOTrevenue 9830/130,000 =>> 7.6 % is overhead

HOV OH in practice 330K/yr or 27.5K/mo

so I brought in 460K/yr with 130K salary

% OH/TOT revenue 330K/460 K=>> 71.7% is overhead

(MGMA 60% average OH for HOV in 2002)

How many days will I have to work to pay my OH?

LOV part time to pay overhead at 10K/yr? < 1 month

3.3 weeks

@ 3 half days week

= 10 half days

making $1000 per 1/2 day

HOV full time to pay my portion of OH? 8.6 months

37.2 weeks

@ 4 full days/wk

= 148.8 full days

making $2218 per full day

How many patients seen per year to pay overhead ??

Pts/wk (at 25/wk) x 3.3 wks to pay part time OH LOV = 83 patients

@ $118/pt collected

Pts/wk (112/wk) x 37.2 wks to pay full time OH HOV = 4166 patients

@ $79.21/pt collected

Collection rate AR 30,60, 90 days?

LOV no cash collections/bad debt department -

all cash pts pay in full at time of service

insurance payments received 14-21 day average, no AR 60,90 accounts

HOV pts sent to collections, billing dept tracking unpaid

accounts

uninsured pts not accepted or cash pts with unpaid balances at visit

insurance payments with larger 30,60,90 ARs to track, denials to

follow

Lack of data on LOV in medical literature

Recruiters, MGMA, medical organizations give statistics based on HOV

practices

LOV practices were the norm 50 years ago, but most docs are not exposed to

LOV data in training, journals or elsewhere and are heavily marketed with

HOV

" opportunities "

So I am open for comments and most appreciative for your thoughts. This is

just the

financial portion of my presentation. I like it because it highlights the

differences in a

dramatic real life way. By the way the 130K/yr is extrapolated into the

first 12 months at

capacity at my " LOVe " practice. I reached capacity 2-3 montsh ago and the #s

have

supported my figures above since. The first 6-8 months were " start-up "

months and not

typical of the future numbers.

Thanks!

Pamela

Pamela Wible, MD

Family & Community Medicine, LLC

3575 st. #220

Eugene, OR 97405

roxywible@...

[Guest guest]

Excellent info and thanks!To clarify- my policy is claims made and it will mature in 5 years at a nondiscounted rateof around $ 8800 from the original quote I received in 2005.  That, of course, does not include rate increases that I expect will happen at intervals - if not yearly.They offer 3/4 time and 1/2 time discounts in proportion to time worked (25% off, 50% off)so I ultimately was quoted a 5 year mature rate of $4400 My #1 year was  1230My #2 year is 1770This may be wildly different in your neck of the woods, but often there are discounts for thefollowing:1) fresh out of residency discounts (for first 3 years or so) these are great!2) first 4 years of policy (before it matures) 3) discounts for risk reduction seminars by the company (2-3 hour course like the DMV) = 3-5%4) Part time discounts of usually 50%, 25% off with many, not all companies#1 and #3 applied to me.I believe the average FP premium for full time these days is 12K, but I want to check on this so 50% discount would bring it down to 6K.  The higher the premium the more money saved with discounts which can be substantial.BTW, in the "LOVe" model your malpractice risk will hit an all time low as compared to HOV.Majority of FP malpractice cases center around system errors and communication problems which are high in the HOV officesPamela About the only sort potentially confusing comment I see is regarding your malpractice cost.  To tell new grads that you only pay $1230/year in malpractice should include a big footnote that explains.  Mine costs $13,000/year & I'm only two years out of residency (no claims).  I realize yours is part time, but even that needs explained further. Also, many carriers won't grant part time policies or else they are not much cheaper. It also needs explained that the cost of claims made policies increase for the first 3-5 years exponentially.  Are you saying that your malpractice premium will max out at $2460/year?  That seems nearly impossible. If you don't clearly explain that to residents in training they might not be making an informed decision. That same thing sort of happened with Gordon's original articles in FPM.  He mentioned that his malpractice costs & costs for Alteer were ridiculously low and that caused a flurry of questions asking for clarification. Those cost numbers basically can't be reproduced now, and new grads need to know both the good & the bad.  They need to know that duplicating this style of practice will be much more difficult in certain locales & with different cost assumptions. LOV (Low Overhead Volume) vs. HOV (High Overhead Volume) numbers - VERY INTEREST Hello all.  I am preparing to give a grand rounds presentation in NY state later next month to inspire the latest grads in the LOV (Low Overhead Volume) model  vs. the HOV (High Overhead Volume) model.   I guess I LOVE the LOV model!  The numbers crunching I did today really highlighted the differences in a visceral way for me. Low Overhead Volume (LOV)     vs.       High Overhead Volume (HOV)       Ultralight Practice                  Assembly line medicine                                                          Low Volume practices in the news --> Housecall MD, Boutique practices                               my personal real life comparisons             OR...      How I saved 26.5 K/month in overhead       2005-current                        2000-2002       LOV (Low Overhead Volume)      HOV (High Overhead Volume)       Self Employed                          Employee with partnership potential       Part Time                                Full Time       3  half days/ week                  4 full days/ week       $130 K/ yr                        $130 K/ yr (base 110K plus bonus)       10 K / yr OH (overhead)            330K/ yr OH (overhead)       <1K mo  OH                        27.5 K mo  OH                   What does an ultralight overhead look like?       My LOV OH       (excluding 3K start up expense) recurring expenses                                    in order of cost                   rent      @ 300/mo                  3600/yr                   Personal health insurance            2200/yr (spouse, me)                   malpractice                  1st yr 1230 (at 50%)                   Medical supplies                  700/yr                   Phone cell + land                  700/yr                   Office liability insurance              500/yr                   Hospital/society Dues            600/yr                   Office supplies                         300/yr                                                       9830 =  819/mo                                                             Compare % OH  (overhead)  LOV & HOV models       My LOV Revenue  2500-3000/wk   =   130K- 156K  (call it 130K)       %  OH/TOTrevenue   9830/130,000     =>>      7.6 % is overhead       HOV  OH in practice 330K/yr or 27.5K/mo       so I brought in 460K/yr with 130K salary        % OH/TOT revenue    330K/460 K=>>     71.7% is overhead       (MGMA 60% average OH for  HOV in 2002)             How many days will I have to work to pay my OH?       LOV  part time to pay overhead at 10K/yr?  < 1 month                       3.3 weeks                    @ 3 half days week                   =  10 half days                     making $1000 per 1/2 day       HOV full time to pay my portion of OH?  8.6 months                     37.2 weeks                      @ 4 full days/wk                   =  148.8 full days             making $2218 per full day             How many patients seen per year to pay overhead ??                               Pts/wk (at 25/wk) x 3.3 wks  to pay part time OH LOV =   83 patients       @ $118/pt collected       Pts/wk (112/wk) x 37.2 wks to pay full time OH HOV   = 4166 patients       @  $79.21/pt collected       Collection rate  AR 30,60, 90 days?       LOV      no cash collections/bad debt department -       all cash pts pay in full at time of service       insurance payments received 14-21 day average, no AR 60,90 accounts             HOV      pts sent to collections, billing dept tracking unpaid accounts       uninsured pts not accepted or cash pts with unpaid balances at visit       insurance payments with larger 30,60,90 ARs to track, denials to follow       Lack of data on LOV in medical literature      Recruiters, MGMA, medical organizations give statistics based on HOV practices LOV practices were the norm 50 years ago, but most docs are not exposed to LOV data in training, journals or elsewhere and are heavily marketed with HOV "opportunities" So I am open for comments and most appreciative for your thoughts.  This is just the financial portion of my presentation. I like it because it highlights the differences in a dramatic real life way.  By the way the 130K/yr is extrapolated into the first 12 months at capacity at my "LOVe" practice. I reached capacity 2-3 montsh ago and the #s have supported my figures above since.  The first 6-8 months were "start-up" months and not typical of the future numbers. Thanks! Pamela Pamela Wible, MD Family & Community Medicine, LLC 3575 st. #220 Eugene, OR 97405 roxywible@...

[Guest guest]

Excellent info and thanks!To clarify- my policy is claims made and it will mature in 5 years at a nondiscounted rateof around $ 8800 from the original quote I received in 2005.  That, of course, does not include rate increases that I expect will happen at intervals - if not yearly.They offer 3/4 time and 1/2 time discounts in proportion to time worked (25% off, 50% off)so I ultimately was quoted a 5 year mature rate of $4400 My #1 year was  1230My #2 year is 1770This may be wildly different in your neck of the woods, but often there are discounts for thefollowing:1) fresh out of residency discounts (for first 3 years or so) these are great!2) first 4 years of policy (before it matures) 3) discounts for risk reduction seminars by the company (2-3 hour course like the DMV) = 3-5%4) Part time discounts of usually 50%, 25% off with many, not all companies#1 and #3 applied to me.I believe the average FP premium for full time these days is 12K, but I want to check on this so 50% discount would bring it down to 6K.  The higher the premium the more money saved with discounts which can be substantial.BTW, in the "LOVe" model your malpractice risk will hit an all time low as compared to HOV.Majority of FP malpractice cases center around system errors and communication problems which are high in the HOV officesPamela About the only sort potentially confusing comment I see is regarding your malpractice cost.  To tell new grads that you only pay $1230/year in malpractice should include a big footnote that explains.  Mine costs $13,000/year & I'm only two years out of residency (no claims).  I realize yours is part time, but even that needs explained further. Also, many carriers won't grant part time policies or else they are not much cheaper. It also needs explained that the cost of claims made policies increase for the first 3-5 years exponentially.  Are you saying that your malpractice premium will max out at $2460/year?  That seems nearly impossible. If you don't clearly explain that to residents in training they might not be making an informed decision. That same thing sort of happened with Gordon's original articles in FPM.  He mentioned that his malpractice costs & costs for Alteer were ridiculously low and that caused a flurry of questions asking for clarification. Those cost numbers basically can't be reproduced now, and new grads need to know both the good & the bad.  They need to know that duplicating this style of practice will be much more difficult in certain locales & with different cost assumptions. LOV (Low Overhead Volume) vs. HOV (High Overhead Volume) numbers - VERY INTEREST Hello all.  I am preparing to give a grand rounds presentation in NY state later next month to inspire the latest grads in the LOV (Low Overhead Volume) model  vs. the HOV (High Overhead Volume) model.   I guess I LOVE the LOV model!  The numbers crunching I did today really highlighted the differences in a visceral way for me. Low Overhead Volume (LOV)     vs.       High Overhead Volume (HOV)       Ultralight Practice                  Assembly line medicine                                                          Low Volume practices in the news --> Housecall MD, Boutique practices                               my personal real life comparisons             OR...      How I saved 26.5 K/month in overhead       2005-current                        2000-2002       LOV (Low Overhead Volume)      HOV (High Overhead Volume)       Self Employed                          Employee with partnership potential       Part Time                                Full Time       3  half days/ week                  4 full days/ week       $130 K/ yr                        $130 K/ yr (base 110K plus bonus)       10 K / yr OH (overhead)            330K/ yr OH (overhead)       <1K mo  OH                        27.5 K mo  OH                   What does an ultralight overhead look like?       My LOV OH       (excluding 3K start up expense) recurring expenses                                    in order of cost                   rent      @ 300/mo                  3600/yr                   Personal health insurance            2200/yr (spouse, me)                   malpractice                  1st yr 1230 (at 50%)                   Medical supplies                  700/yr                   Phone cell + land                  700/yr                   Office liability insurance              500/yr                   Hospital/society Dues            600/yr                   Office supplies                         300/yr                                                       9830 =  819/mo                                                             Compare % OH  (overhead)  LOV & HOV models       My LOV Revenue  2500-3000/wk   =   130K- 156K  (call it 130K)       %  OH/TOTrevenue   9830/130,000     =>>      7.6 % is overhead       HOV  OH in practice 330K/yr or 27.5K/mo       so I brought in 460K/yr with 130K salary        % OH/TOT revenue    330K/460 K=>>     71.7% is overhead       (MGMA 60% average OH for  HOV in 2002)             How many days will I have to work to pay my OH?       LOV  part time to pay overhead at 10K/yr?  < 1 month                       3.3 weeks                    @ 3 half days week                   =  10 half days                     making $1000 per 1/2 day       HOV full time to pay my portion of OH?  8.6 months                     37.2 weeks                      @ 4 full days/wk                   =  148.8 full days             making $2218 per full day             How many patients seen per year to pay overhead ??                               Pts/wk (at 25/wk) x 3.3 wks  to pay part time OH LOV =   83 patients       @ $118/pt collected       Pts/wk (112/wk) x 37.2 wks to pay full time OH HOV   = 4166 patients       @  $79.21/pt collected       Collection rate  AR 30,60, 90 days?       LOV      no cash collections/bad debt department -       all cash pts pay in full at time of service       insurance payments received 14-21 day average, no AR 60,90 accounts             HOV      pts sent to collections, billing dept tracking unpaid accounts       uninsured pts not accepted or cash pts with unpaid balances at visit       insurance payments with larger 30,60,90 ARs to track, denials to follow       Lack of data on LOV in medical literature      Recruiters, MGMA, medical organizations give statistics based on HOV practices LOV practices were the norm 50 years ago, but most docs are not exposed to LOV data in training, journals or elsewhere and are heavily marketed with HOV "opportunities" So I am open for comments and most appreciative for your thoughts.  This is just the financial portion of my presentation. I like it because it highlights the differences in a dramatic real life way.  By the way the 130K/yr is extrapolated into the first 12 months at capacity at my "LOVe" practice. I reached capacity 2-3 montsh ago and the #s have supported my figures above since.  The first 6-8 months were "start-up" months and not typical of the future numbers. Thanks! Pamela Pamela Wible, MD Family & Community Medicine, LLC 3575 st. #220 Eugene, OR 97405 roxywible@...

[Guest guest]

One other assumption in your numbers that might need an aside discussion is

the average of $118/pt. I guess that stems from the previous discussions

here regarding your (apparently) much higher reimbursement in Oregon & your

high coding trends (as I recall you code >50% 99215's). $118/pt is a pretty

ambitious goal for most of us. If I were giving the talk I would be sure to

clarify that number & mention that it may not be attainable in all

geographic areas. If someone is only able to average $60/pt then obviously

they will need to see twice the number of pt's you are quoting. Payor mix &

local reimbursement trends can make a huge difference in these assumptions.

Coding trends is a whole other topic! I personally would not feel

comfortable coding >50% of my visits as a 99215, but that is just different

for each of us.

LOV (Low Overhead Volume) vs. HOV (High

Overhead Volume) numbers - VERY INTEREST

Hello all. I am preparing to give a grand rounds presentation in NY state

later next month

to inspire the latest grads in the LOV (Low Overhead Volume) model vs. the

HOV (High

Overhead Volume) model. I guess I LOVE the LOV model! The numbers

crunching I did

today really highlighted the differences in a visceral way for me.

Low Overhead Volume (LOV) vs. High Overhead Volume (HOV)

Ultralight Practice Assembly line medicine

Low Volume practices in the news --> Housecall MD, Boutique practices

my personal real life comparisons

OR... How I saved 26.5 K/month in overhead

2005-current 2000-2002

LOV (Low Overhead Volume) HOV (High Overhead Volume)

Self Employed Employee with partnership

potential

Part Time Full Time

3 half days/ week 4 full days/ week

$130 K/ yr $130 K/ yr (base 110K plus

bonus)

10 K / yr OH (overhead) 330K/ yr OH (overhead)

<1K mo OH 27.5 K mo OH

What does an ultralight overhead look like?

My LOV OH (excluding 3K start up expense) recurring expenses

in order of cost

rent @ 300/mo 3600/yr

Personal health insurance 2200/yr

(spouse, me)

malpractice 1st yr 1230 (at 50%)

Medical supplies 700/yr

Phone cell + land 700/yr

Office liability insurance 500/yr

Hospital/society Dues 600/yr

Office supplies 300/yr

9830

= 819/mo

Compare % OH (overhead) LOV & HOV models

My LOV Revenue 2500-3000/wk = 130K- 156K (call it 130K)

% OH/TOTrevenue 9830/130,000 =>> 7.6 % is overhead

HOV OH in practice 330K/yr or 27.5K/mo

so I brought in 460K/yr with 130K salary

% OH/TOT revenue 330K/460 K=>> 71.7% is overhead

(MGMA 60% average OH for HOV in 2002)

How many days will I have to work to pay my OH?

LOV part time to pay overhead at 10K/yr? < 1 month

3.3 weeks

@ 3 half days week

= 10 half days

making $1000 per 1/2 day

HOV full time to pay my portion of OH? 8.6 months

37.2 weeks

@ 4 full days/wk

= 148.8 full days

making $2218 per full day

How many patients seen per year to pay overhead ??

Pts/wk (at 25/wk) x 3.3 wks to pay part time OH LOV = 83 patients

@ $118/pt collected

Pts/wk (112/wk) x 37.2 wks to pay full time OH HOV = 4166 patients

@ $79.21/pt collected

Collection rate AR 30,60, 90 days?

LOV no cash collections/bad debt department -

all cash pts pay in full at time of service

insurance payments received 14-21 day average, no AR 60,90 accounts

HOV pts sent to collections, billing dept tracking unpaid

accounts

uninsured pts not accepted or cash pts with unpaid balances at visit

insurance payments with larger 30,60,90 ARs to track, denials to

follow

Lack of data on LOV in medical literature

Recruiters, MGMA, medical organizations give statistics based on HOV

practices

LOV practices were the norm 50 years ago, but most docs are not exposed to

LOV data in training, journals or elsewhere and are heavily marketed with

HOV

" opportunities "

So I am open for comments and most appreciative for your thoughts. This is

just the

financial portion of my presentation. I like it because it highlights the

differences in a

dramatic real life way. By the way the 130K/yr is extrapolated into the

first 12 months at

capacity at my " LOVe " practice. I reached capacity 2-3 montsh ago and the #s

have

supported my figures above since. The first 6-8 months were " start-up "

months and not

typical of the future numbers.

Thanks!

Pamela

Pamela Wible, MD

Family & Community Medicine, LLC

3575 st. #220

Eugene, OR 97405

roxywible@...

[Guest guest]

One other assumption in your numbers that might need an aside discussion is

the average of $118/pt. I guess that stems from the previous discussions

here regarding your (apparently) much higher reimbursement in Oregon & your

high coding trends (as I recall you code >50% 99215's). $118/pt is a pretty

ambitious goal for most of us. If I were giving the talk I would be sure to

clarify that number & mention that it may not be attainable in all

geographic areas. If someone is only able to average $60/pt then obviously

they will need to see twice the number of pt's you are quoting. Payor mix &

local reimbursement trends can make a huge difference in these assumptions.

Coding trends is a whole other topic! I personally would not feel

comfortable coding >50% of my visits as a 99215, but that is just different

for each of us.

LOV (Low Overhead Volume) vs. HOV (High

Overhead Volume) numbers - VERY INTEREST

Hello all. I am preparing to give a grand rounds presentation in NY state

later next month

to inspire the latest grads in the LOV (Low Overhead Volume) model vs. the

HOV (High

Overhead Volume) model. I guess I LOVE the LOV model! The numbers

crunching I did

today really highlighted the differences in a visceral way for me.

Low Overhead Volume (LOV) vs. High Overhead Volume (HOV)

Ultralight Practice Assembly line medicine

Low Volume practices in the news --> Housecall MD, Boutique practices

my personal real life comparisons

OR... How I saved 26.5 K/month in overhead

2005-current 2000-2002

LOV (Low Overhead Volume) HOV (High Overhead Volume)

Self Employed Employee with partnership

potential

Part Time Full Time

3 half days/ week 4 full days/ week

$130 K/ yr $130 K/ yr (base 110K plus

bonus)

10 K / yr OH (overhead) 330K/ yr OH (overhead)

<1K mo OH 27.5 K mo OH

What does an ultralight overhead look like?

My LOV OH (excluding 3K start up expense) recurring expenses

in order of cost

rent @ 300/mo 3600/yr

Personal health insurance 2200/yr

(spouse, me)

malpractice 1st yr 1230 (at 50%)

Medical supplies 700/yr

Phone cell + land 700/yr

Office liability insurance 500/yr

Hospital/society Dues 600/yr

Office supplies 300/yr

9830

= 819/mo

Compare % OH (overhead) LOV & HOV models

My LOV Revenue 2500-3000/wk = 130K- 156K (call it 130K)

% OH/TOTrevenue 9830/130,000 =>> 7.6 % is overhead

HOV OH in practice 330K/yr or 27.5K/mo

so I brought in 460K/yr with 130K salary

% OH/TOT revenue 330K/460 K=>> 71.7% is overhead

(MGMA 60% average OH for HOV in 2002)

How many days will I have to work to pay my OH?

LOV part time to pay overhead at 10K/yr? < 1 month

3.3 weeks

@ 3 half days week

= 10 half days

making $1000 per 1/2 day

HOV full time to pay my portion of OH? 8.6 months

37.2 weeks

@ 4 full days/wk

= 148.8 full days

making $2218 per full day

How many patients seen per year to pay overhead ??

Pts/wk (at 25/wk) x 3.3 wks to pay part time OH LOV = 83 patients

@ $118/pt collected

Pts/wk (112/wk) x 37.2 wks to pay full time OH HOV = 4166 patients

@ $79.21/pt collected

Collection rate AR 30,60, 90 days?

LOV no cash collections/bad debt department -

all cash pts pay in full at time of service

insurance payments received 14-21 day average, no AR 60,90 accounts

HOV pts sent to collections, billing dept tracking unpaid

accounts

uninsured pts not accepted or cash pts with unpaid balances at visit

insurance payments with larger 30,60,90 ARs to track, denials to

follow

Lack of data on LOV in medical literature

Recruiters, MGMA, medical organizations give statistics based on HOV

practices

LOV practices were the norm 50 years ago, but most docs are not exposed to

LOV data in training, journals or elsewhere and are heavily marketed with

HOV

" opportunities "

So I am open for comments and most appreciative for your thoughts. This is

just the

financial portion of my presentation. I like it because it highlights the

differences in a

dramatic real life way. By the way the 130K/yr is extrapolated into the

first 12 months at

capacity at my " LOVe " practice. I reached capacity 2-3 montsh ago and the #s

have

supported my figures above since. The first 6-8 months were " start-up "

months and not

typical of the future numbers.

Thanks!

Pamela

Pamela Wible, MD

Family & Community Medicine, LLC

3575 st. #220

Eugene, OR 97405

roxywible@...

[Guest guest]

Thanks and great point.  I do code < 10% 99215.  I code many 99214s - probably 60 % or more (at 167 and get pretty good reimbursement) I do a fair number of physicals which reimburse highly as well.  About once weekly I may use one of those prolonged service codes which is very great financially(99214 at 167 PLUS 99354 at 179 for visits that are over an hour => 346!)  I do skin procedures as well. This all balances nicely against the self pay group who pay anywhere between 40-120 dollars for visits, mostly on the low end.Eventually I will do group visits and probably code 99214s for groups of 5-10 people over 2-3 hours which would create an incredible stream of money.It may seem like I am driven by money, but I am really not that motivated to earn much money. I have very low personal expenses (and practice expenses) and I happen to be in a state or region that reimburses well.Regarding malpractice, Oregon is labeled as a CRISIS state by the AMA and I certainly do not feel I am in crisis. There must be many microclimates from region to region with dramatic variation on everything from malpractice premiums to insurance reimbursement (even within the same carrier)  Go figure....Thanks for your thoughts!Pamela One other assumption in your numbers that might need an aside discussion is the average of $118/pt.  I guess that stems from the previous discussions here regarding your (apparently) much higher reimbursement in Oregon & your high coding trends (as I recall you code >50% 99215's).  $118/pt is a pretty ambitious goal for most of us.  If I were giving the talk I would be sure to clarify that number & mention that it may not be attainable in all geographic areas.  If someone is only able to average $60/pt then obviously they will need to see twice the number of pt's you are quoting.  Payor mix & local reimbursement trends can make a huge difference in these assumptions. Coding trends is a whole other topic!  I personally would not feel comfortable coding >50% of my visits as a 99215, but that is just different for each of us. LOV (Low Overhead Volume) vs. HOV (High Overhead Volume) numbers - VERY INTEREST Hello all.  I am preparing to give a grand rounds presentation in NY state later next month to inspire the latest grads in the LOV (Low Overhead Volume) model  vs. the HOV (High Overhead Volume) model.   I guess I LOVE the LOV model!  The numbers crunching I did today really highlighted the differences in a visceral way for me. Low Overhead Volume (LOV)     vs.       High Overhead Volume (HOV)       Ultralight Practice                  Assembly line medicine                                                          Low Volume practices in the news --> Housecall MD, Boutique practices                               my personal real life comparisons             OR...      How I saved 26.5 K/month in overhead       2005-current                        2000-2002       LOV (Low Overhead Volume)      HOV (High Overhead Volume)       Self Employed                          Employee with partnership potential       Part Time                                Full Time       3  half days/ week                  4 full days/ week       $130 K/ yr                        $130 K/ yr (base 110K plus bonus)       10 K / yr OH (overhead)            330K/ yr OH (overhead)       <1K mo  OH                        27.5 K mo  OH                   What does an ultralight overhead look like?       My LOV OH       (excluding 3K start up expense) recurring expenses                                    in order of cost                   rent      @ 300/mo                  3600/yr                   Personal health insurance            2200/yr (spouse, me)                   malpractice                  1st yr 1230 (at 50%)                   Medical supplies                  700/yr                   Phone cell + land                  700/yr                   Office liability insurance              500/yr                   Hospital/society Dues            600/yr                   Office supplies                         300/yr                                                       9830 =  819/mo                                                             Compare % OH  (overhead)  LOV & HOV models       My LOV Revenue  2500-3000/wk   =   130K- 156K  (call it 130K)       %  OH/TOTrevenue   9830/130,000     =>>      7.6 % is overhead       HOV  OH in practice 330K/yr or 27.5K/mo       so I brought in 460K/yr with 130K salary        % OH/TOT revenue    330K/460 K=>>     71.7% is overhead       (MGMA 60% average OH for  HOV in 2002)             How many days will I have to work to pay my OH?       LOV  part time to pay overhead at 10K/yr?  < 1 month                       3.3 weeks                    @ 3 half days week                   =  10 half days                     making $1000 per 1/2 day       HOV full time to pay my portion of OH?  8.6 months                     37.2 weeks                      @ 4 full days/wk                   =  148.8 full days             making $2218 per full day             How many patients seen per year to pay overhead ??                               Pts/wk (at 25/wk) x 3.3 wks  to pay part time OH LOV =   83 patients       @ $118/pt collected       Pts/wk (112/wk) x 37.2 wks to pay full time OH HOV   = 4166 patients       @  $79.21/pt collected       Collection rate  AR 30,60, 90 days?       LOV      no cash collections/bad debt department -       all cash pts pay in full at time of service       insurance payments received 14-21 day average, no AR 60,90 accounts             HOV      pts sent to collections, billing dept tracking unpaid accounts       uninsured pts not accepted or cash pts with unpaid balances at visit       insurance payments with larger 30,60,90 ARs to track, denials to follow       Lack of data on LOV in medical literature      Recruiters, MGMA, medical organizations give statistics based on HOV practices LOV practices were the norm 50 years ago, but most docs are not exposed to LOV data in training, journals or elsewhere and are heavily marketed with HOV "opportunities" So I am open for comments and most appreciative for your thoughts.  This is just the financial portion of my presentation. I like it because it highlights the differences in a dramatic real life way.  By the way the 130K/yr is extrapolated into the first 12 months at capacity at my "LOVe" practice. I reached capacity 2-3 montsh ago and the #s have supported my figures above since.  The first 6-8 months were "start-up" months and not typical of the future numbers. Thanks! Pamela Pamela Wible, MD Family & Community Medicine, LLC 3575 st. #220 Eugene, OR 97405 roxywible@...

[Guest guest]

Thanks and great point.  I do code < 10% 99215.  I code many 99214s - probably 60 % or more (at 167 and get pretty good reimbursement) I do a fair number of physicals which reimburse highly as well.  About once weekly I may use one of those prolonged service codes which is very great financially(99214 at 167 PLUS 99354 at 179 for visits that are over an hour => 346!)  I do skin procedures as well. This all balances nicely against the self pay group who pay anywhere between 40-120 dollars for visits, mostly on the low end.Eventually I will do group visits and probably code 99214s for groups of 5-10 people over 2-3 hours which would create an incredible stream of money.It may seem like I am driven by money, but I am really not that motivated to earn much money. I have very low personal expenses (and practice expenses) and I happen to be in a state or region that reimburses well.Regarding malpractice, Oregon is labeled as a CRISIS state by the AMA and I certainly do not feel I am in crisis. There must be many microclimates from region to region with dramatic variation on everything from malpractice premiums to insurance reimbursement (even within the same carrier)  Go figure....Thanks for your thoughts!Pamela One other assumption in your numbers that might need an aside discussion is the average of $118/pt.  I guess that stems from the previous discussions here regarding your (apparently) much higher reimbursement in Oregon & your high coding trends (as I recall you code >50% 99215's).  $118/pt is a pretty ambitious goal for most of us.  If I were giving the talk I would be sure to clarify that number & mention that it may not be attainable in all geographic areas.  If someone is only able to average $60/pt then obviously they will need to see twice the number of pt's you are quoting.  Payor mix & local reimbursement trends can make a huge difference in these assumptions. Coding trends is a whole other topic!  I personally would not feel comfortable coding >50% of my visits as a 99215, but that is just different for each of us. LOV (Low Overhead Volume) vs. HOV (High Overhead Volume) numbers - VERY INTEREST Hello all.  I am preparing to give a grand rounds presentation in NY state later next month to inspire the latest grads in the LOV (Low Overhead Volume) model  vs. the HOV (High Overhead Volume) model.   I guess I LOVE the LOV model!  The numbers crunching I did today really highlighted the differences in a visceral way for me. Low Overhead Volume (LOV)     vs.       High Overhead Volume (HOV)       Ultralight Practice                  Assembly line medicine                                                          Low Volume practices in the news --> Housecall MD, Boutique practices                               my personal real life comparisons             OR...      How I saved 26.5 K/month in overhead       2005-current                        2000-2002       LOV (Low Overhead Volume)      HOV (High Overhead Volume)       Self Employed                          Employee with partnership potential       Part Time                                Full Time       3  half days/ week                  4 full days/ week       $130 K/ yr                        $130 K/ yr (base 110K plus bonus)       10 K / yr OH (overhead)            330K/ yr OH (overhead)       <1K mo  OH                        27.5 K mo  OH                   What does an ultralight overhead look like?       My LOV OH       (excluding 3K start up expense) recurring expenses                                    in order of cost                   rent      @ 300/mo                  3600/yr                   Personal health insurance            2200/yr (spouse, me)                   malpractice                  1st yr 1230 (at 50%)                   Medical supplies                  700/yr                   Phone cell + land                  700/yr                   Office liability insurance              500/yr                   Hospital/society Dues            600/yr                   Office supplies                         300/yr                                                       9830 =  819/mo                                                             Compare % OH  (overhead)  LOV & HOV models       My LOV Revenue  2500-3000/wk   =   130K- 156K  (call it 130K)       %  OH/TOTrevenue   9830/130,000     =>>      7.6 % is overhead       HOV  OH in practice 330K/yr or 27.5K/mo       so I brought in 460K/yr with 130K salary        % OH/TOT revenue    330K/460 K=>>     71.7% is overhead       (MGMA 60% average OH for  HOV in 2002)             How many days will I have to work to pay my OH?       LOV  part time to pay overhead at 10K/yr?  < 1 month                       3.3 weeks                    @ 3 half days week                   =  10 half days                     making $1000 per 1/2 day       HOV full time to pay my portion of OH?  8.6 months                     37.2 weeks                      @ 4 full days/wk                   =  148.8 full days             making $2218 per full day             How many patients seen per year to pay overhead ??                               Pts/wk (at 25/wk) x 3.3 wks  to pay part time OH LOV =   83 patients       @ $118/pt collected       Pts/wk (112/wk) x 37.2 wks to pay full time OH HOV   = 4166 patients       @  $79.21/pt collected       Collection rate  AR 30,60, 90 days?       LOV      no cash collections/bad debt department -       all cash pts pay in full at time of service       insurance payments received 14-21 day average, no AR 60,90 accounts             HOV      pts sent to collections, billing dept tracking unpaid accounts       uninsured pts not accepted or cash pts with unpaid balances at visit       insurance payments with larger 30,60,90 ARs to track, denials to follow       Lack of data on LOV in medical literature      Recruiters, MGMA, medical organizations give statistics based on HOV practices LOV practices were the norm 50 years ago, but most docs are not exposed to LOV data in training, journals or elsewhere and are heavily marketed with HOV "opportunities" So I am open for comments and most appreciative for your thoughts.  This is just the financial portion of my presentation. I like it because it highlights the differences in a dramatic real life way.  By the way the 130K/yr is extrapolated into the first 12 months at capacity at my "LOVe" practice. I reached capacity 2-3 montsh ago and the #s have supported my figures above since.  The first 6-8 months were "start-up" months and not typical of the future numbers. Thanks! Pamela Pamela Wible, MD Family & Community Medicine, LLC 3575 st. #220 Eugene, OR 97405 roxywible@...

[Guest guest]

Sounds like you are doing all of the right

stuff & your coding, etc sounds like they are excellent. Some of the

variations, such as regional malpractice rates & reimbursement, are

generally tough to do much about (except to move of course). It is hard

to believe that some here get $65 for a 99214 & others get $178! Wow.

LOV (Low Overhead

Volume) vs. HOV (High

Overhead Volume) numbers - VERY INTEREST

Hello all. I am preparing to give a grand

rounds presentation in NY state

later next month

to inspire the latest grads in the LOV (Low

Overhead Volume) model vs. the

HOV (High

Overhead Volume) model. I guess I LOVE

the LOV model! The numbers

crunching I did

today really highlighted the differences in a

visceral way for me.

Low Overhead Volume (LOV)

vs. High Overhead Volume (HOV)

Ultralight

Practice

Assembly line medicine

Low Volume practices in the news --> Housecall

MD, Boutique practices

my personal real

life comparisons

OR... How I saved

26.5 K/month in overhead

2005-current

2000-2002

LOV (Low Overhead

Volume) HOV (High Overhead Volume)

Self

Employed

Employee with partnership

potential

Part

Time

Full Time

3 half days/

week

4 full days/ week

$130 K/

yr

$130 K/ yr (base

110K plus

bonus)

10 K / yr OH

(overhead) 330K/

yr OH (overhead)

<1K mo

OH

27.5 K mo

OH

What does an ultralight overhead look like?

My LOV OH

(excluding 3K start up expense) recurring

expenses

in order of cost

rent @ 300/mo

3600/yr

Personal health

insurance 2200/yr

(spouse, me)

malpractice

1st yr 1230 (at 50%)

Medical

supplies

700/yr

Phone cell +

land

700/yr

Office liability

insurance

500/yr

Hospital/society

Dues 600/yr

Office

supplies

300/yr

9830

= 819/mo

Compare % OH (overhead) LOV &

HOV models

My LOV

Revenue 2500-3000/wk = 130K- 156K (call it

130K)

%

OH/TOTrevenue 9830/130,000

=>> 7.6 % is overhead

HOV OH in

practice 330K/yr or 27.5K/mo

so I brought in

460K/yr with 130K salary

% OH/TOT

revenue 330K/460 K=>> 71.7% is

overhead

(MGMA 60% average

OH for HOV in 2002)

How many days will

I have to work to pay my OH?

LOV part time

to pay overhead at 10K/yr? < 1 month

3.3 weeks

@ 3 half days

week

= 10 half

days

making $1000 per 1/2 day

HOV full time to

pay my portion of OH? 8.6 months

37.2

weeks

@ 4 full days/wk

= 148.8

full days

making $2218 per full day

How many patients

seen per year to pay overhead ??

Pts/wk (at 25/wk) x

3.3 wks to pay part time OH LOV = 83 patients

@ $118/pt collected

Pts/wk (112/wk) x

37.2 wks to pay full time OH HOV = 4166 patients

@ $79.21/pt collected

Collection

rate AR 30,60, 90 days?

LOV no cash collections/bad debt department -

all cash pts pay in

full at time of service

insurance payments

received 14-21 day average, no AR 60,90 accounts

HOV pts sent to collections, billing dept

tracking unpaid

accounts

uninsured pts not

accepted or cash pts with unpaid balances at visit

insurance payments

with larger 30,60,90 ARs to track, denials to

follow

Lack of data on LOV

in medical literature

Recruiters, MGMA, medical organizations give

statistics based on HOV

practices

LOV practices were the norm 50 years ago, but most

docs are not exposed to

LOV data in training, journals or elsewhere and

are heavily marketed with

HOV

" opportunities "

So I am open for comments and most appreciative

for your thoughts. This is

just the

financial portion of my presentation. I like it

because it highlights the

differences in a

dramatic real life way. By the way the

130K/yr is extrapolated into the

first 12 months at

capacity at my " LOVe " practice. I

reached capacity 2-3 montsh ago and the #s

have

supported my figures above since. The first

6-8 months were " start-up "

months and not

typical of the future numbers.

Thanks!

Pamela

Pamela Wible, MD

Family & Community Medicine, LLC

3575 st. #220

Eugene, OR 97405

roxywible@...

[Guest guest]

Sounds like you are doing all of the right

stuff & your coding, etc sounds like they are excellent. Some of the

variations, such as regional malpractice rates & reimbursement, are

generally tough to do much about (except to move of course). It is hard

to believe that some here get $65 for a 99214 & others get $178! Wow.

LOV (Low Overhead

Volume) vs. HOV (High

Overhead Volume) numbers - VERY INTEREST

Hello all. I am preparing to give a grand

rounds presentation in NY state

later next month

to inspire the latest grads in the LOV (Low

Overhead Volume) model vs. the

HOV (High

Overhead Volume) model. I guess I LOVE

the LOV model! The numbers

crunching I did

today really highlighted the differences in a

visceral way for me.

Low Overhead Volume (LOV)

vs. High Overhead Volume (HOV)

Ultralight

Practice

Assembly line medicine

Low Volume practices in the news --> Housecall

MD, Boutique practices

my personal real

life comparisons

OR... How I saved

26.5 K/month in overhead

2005-current

2000-2002

LOV (Low Overhead

Volume) HOV (High Overhead Volume)

Self

Employed

Employee with partnership

potential

Part

Time

Full Time

3 half days/

week

4 full days/ week

$130 K/

yr

$130 K/ yr (base

110K plus

bonus)

10 K / yr OH

(overhead) 330K/

yr OH (overhead)

<1K mo

OH

27.5 K mo

OH

What does an ultralight overhead look like?

My LOV OH

(excluding 3K start up expense) recurring

expenses

in order of cost

rent @ 300/mo

3600/yr

Personal health

insurance 2200/yr

(spouse, me)

malpractice

1st yr 1230 (at 50%)

Medical

supplies

700/yr

Phone cell +

land

700/yr

Office liability

insurance

500/yr

Hospital/society

Dues 600/yr

Office

supplies

300/yr

9830

= 819/mo

Compare % OH (overhead) LOV &

HOV models

My LOV

Revenue 2500-3000/wk = 130K- 156K (call it

130K)

%

OH/TOTrevenue 9830/130,000

=>> 7.6 % is overhead

HOV OH in

practice 330K/yr or 27.5K/mo

so I brought in

460K/yr with 130K salary

% OH/TOT

revenue 330K/460 K=>> 71.7% is

overhead

(MGMA 60% average

OH for HOV in 2002)

How many days will

I have to work to pay my OH?

LOV part time

to pay overhead at 10K/yr? < 1 month

3.3 weeks

@ 3 half days

week

= 10 half

days

making $1000 per 1/2 day

HOV full time to

pay my portion of OH? 8.6 months

37.2

weeks

@ 4 full days/wk

= 148.8

full days

making $2218 per full day

How many patients

seen per year to pay overhead ??

Pts/wk (at 25/wk) x

3.3 wks to pay part time OH LOV = 83 patients

@ $118/pt collected

Pts/wk (112/wk) x

37.2 wks to pay full time OH HOV = 4166 patients

@ $79.21/pt collected

Collection

rate AR 30,60, 90 days?

LOV no cash collections/bad debt department -

all cash pts pay in

full at time of service

insurance payments

received 14-21 day average, no AR 60,90 accounts

HOV pts sent to collections, billing dept

tracking unpaid

accounts

uninsured pts not

accepted or cash pts with unpaid balances at visit

insurance payments

with larger 30,60,90 ARs to track, denials to

follow

Lack of data on LOV

in medical literature

Recruiters, MGMA, medical organizations give

statistics based on HOV

practices

LOV practices were the norm 50 years ago, but most

docs are not exposed to

LOV data in training, journals or elsewhere and

are heavily marketed with

HOV

" opportunities "

So I am open for comments and most appreciative

for your thoughts. This is

just the

financial portion of my presentation. I like it

because it highlights the

differences in a

dramatic real life way. By the way the

130K/yr is extrapolated into the

first 12 months at

capacity at my " LOVe " practice. I

reached capacity 2-3 montsh ago and the #s

have

supported my figures above since. The first

6-8 months were " start-up "

months and not

typical of the future numbers.

Thanks!

Pamela

Pamela Wible, MD

Family & Community Medicine, LLC

3575 st. #220

Eugene, OR 97405

roxywible@...

[Guest guest]

Sign me up for a trip/lifetime in Oregon pamela wible wrote: Thanks and great point. I do code < 10% 99215. I code many 99214s - probably 60 % or more (at 167 and get pretty good reimbursement) I do a fair number of physicals which reimburse highly as well. About once weekly I may use one of those prolonged service codes which is very great financially (99214 at 167 PLUS 99354 at 179 for visits that are over an hour => 346!) I do skin procedures as well. This all balances nicely against the self pay group who pay anywhere between 40-120 dollars for visits, mostly on the low end. Eventually I will do group visits and probably code

99214s for groups of 5-10 people over 2-3 hours which would create an incredible stream of money. It may seem like I am driven by money, but I am really not that motivated to earn much money. I have very low personal expenses (and practice expenses) and I happen to be in a state or region that reimburses well. Regarding malpractice, Oregon is labeled as a CRISIS state by the AMA and I certainly do not feel I am in crisis. There must be many microclimates from region to region with dramatic variation on everything from malpractice premiums to insurance reimbursement (even within the same carrier) Go figure.... Thanks for your thoughts! Pamela One other assumption in your numbers that might need an aside discussion isthe average of $118/pt. I guess that stems from the previous discussionshere regarding your (apparently) much higher reimbursement in Oregon & yourhigh coding trends (as I recall you code >50% 99215's). $118/pt is a prettyambitious goal for most of us. If I were giving the talk I would be sure toclarify that number & mention that it may not be attainable in allgeographic areas. If someone is only able to average $60/pt then obviouslythey will need to see twice the number of pt's you are quoting. Payor mix & local reimbursement trends can make a huge difference in these assumptions.Coding trends is a whole other topic! I personally would not feelcomfortable coding >50% of my

visits as a 99215, but that is just differentfor each of us.-----Original Message-----From: [mailto: ] On Behalf Of roxywibleSent: Wednesday, March 01, 2006 12:49 AMTo: Subject: LOV (Low Overhead Volume) vs. HOV (HighOverhead Volume) numbers - VERY INTERESTHello all. I am preparing to give a grand rounds presentation in NY statelater next month to inspire the latest grads in the LOV (Low Overhead Volume) model vs. theHOV (High Overhead Volume) model. I guess I LOVE the LOV model! The numberscrunching I did today really highlighted the differences in a visceral way for

me.Low Overhead Volume (LOV) vs. High Overhead Volume (HOV) Ultralight Practice Assembly line medicine Low Volume practices in the news --> Housecall MD, Boutique practices my personal real life comparisons OR... How I

saved 26.5 K/month in overhead 2005-current 2000-2002 LOV (Low Overhead Volume) HOV (High Overhead Volume) Self Employed Employee with partnershippotential Part Time Full Time 3 half days/ week 4 full days/ week $130 K/

yr $130 K/ yr (base 110K plusbonus) 10 K / yr OH (overhead) 330K/ yr OH (overhead) <1K mo OH 27.5 K mo OH What does an ultralight overhead look like? My LOV OH (excluding 3K start up expense) recurring expenses in order of

cost rent @ 300/mo 3600/yr Personal health insurance 2200/yr(spouse, me) malpractice 1st yr 1230 (at 50%) Medical supplies 700/yr Phone

cell + land 700/yr Office liability insurance 500/yr Hospital/society Dues 600/yr Office supplies 300/yr

9830= 819/mo Compare % OH (overhead) LOV & HOV models My LOV Revenue 2500-3000/wk = 130K- 156K (call it 130K) % OH/TOTrevenue 9830/130,000 =>> 7.6 % is overhead HOV OH in practice 330K/yr or 27.5K/mo so I brought in 460K/yr with 130K salary % OH/TOT revenue 330K/460

K=>> 71.7% is overhead (MGMA 60% average OH for HOV in 2002) How many days will I have to work to pay my OH? LOV part time to pay overhead at 10K/yr? < 1 month 3.3 weeks @ 3 half days week = 10 half days making $1000 per 1/2 day HOV full time to pay my portion of OH? 8.6 months

37.2 weeks @ 4 full days/wk = 148.8 full days making $2218 per full day How many patients seen per year to pay overhead ?? Pts/wk (at 25/wk) x 3.3 wks to pay part time OH LOV = 83 patients @ $118/pt collected Pts/wk (112/wk) x 37.2 wks to pay full time OH HOV = 4166

patients @ $79.21/pt collected Collection rate AR 30,60, 90 days? LOV no cash collections/bad debt department - all cash pts pay in full at time of service insurance payments received 14-21 day average, no AR 60,90 accounts HOV pts sent to collections, billing dept tracking unpaidaccounts uninsured pts not accepted or cash pts with unpaid balances at visit insurance payments with larger 30,60,90 ARs to track, denials tofollow Lack of data on LOV in medical literature Recruiters, MGMA, medical organizations

give statistics based on HOVpracticesLOV practices were the norm 50 years ago, but most docs are not exposed toLOV data in training, journals or elsewhere and are heavily marketed withHOV"opportunities"So I am open for comments and most appreciative for your thoughts. This isjust the financial portion of my presentation. I like it because it highlights thedifferences in a dramatic real life way. By the way the 130K/yr is extrapolated into thefirst 12 months at capacity at my "LOVe" practice. I reached capacity 2-3 montsh ago and the #shave supported my figures above since. The first 6-8 months were "start-up"months and not typical of the future numbers. Thanks!PamelaPamela Wible, MDFamily & Community Medicine, LLC3575 st. #220 Eugene, OR 97405roxywible@...

[Guest guest]

Sign me up for a trip/lifetime in Oregon pamela wible wrote: Thanks and great point. I do code < 10% 99215. I code many 99214s - probably 60 % or more (at 167 and get pretty good reimbursement) I do a fair number of physicals which reimburse highly as well. About once weekly I may use one of those prolonged service codes which is very great financially (99214 at 167 PLUS 99354 at 179 for visits that are over an hour => 346!) I do skin procedures as well. This all balances nicely against the self pay group who pay anywhere between 40-120 dollars for visits, mostly on the low end. Eventually I will do group visits and probably code

99214s for groups of 5-10 people over 2-3 hours which would create an incredible stream of money. It may seem like I am driven by money, but I am really not that motivated to earn much money. I have very low personal expenses (and practice expenses) and I happen to be in a state or region that reimburses well. Regarding malpractice, Oregon is labeled as a CRISIS state by the AMA and I certainly do not feel I am in crisis. There must be many microclimates from region to region with dramatic variation on everything from malpractice premiums to insurance reimbursement (even within the same carrier) Go figure.... Thanks for your thoughts! Pamela One other assumption in your numbers that might need an aside discussion isthe average of $118/pt. I guess that stems from the previous discussionshere regarding your (apparently) much higher reimbursement in Oregon & yourhigh coding trends (as I recall you code >50% 99215's). $118/pt is a prettyambitious goal for most of us. If I were giving the talk I would be sure toclarify that number & mention that it may not be attainable in allgeographic areas. If someone is only able to average $60/pt then obviouslythey will need to see twice the number of pt's you are quoting. Payor mix & local reimbursement trends can make a huge difference in these assumptions.Coding trends is a whole other topic! I personally would not feelcomfortable coding >50% of my

visits as a 99215, but that is just differentfor each of us.-----Original Message-----From: [mailto: ] On Behalf Of roxywibleSent: Wednesday, March 01, 2006 12:49 AMTo: Subject: LOV (Low Overhead Volume) vs. HOV (HighOverhead Volume) numbers - VERY INTERESTHello all. I am preparing to give a grand rounds presentation in NY statelater next month to inspire the latest grads in the LOV (Low Overhead Volume) model vs. theHOV (High Overhead Volume) model. I guess I LOVE the LOV model! The numberscrunching I did today really highlighted the differences in a visceral way for

me.Low Overhead Volume (LOV) vs. High Overhead Volume (HOV) Ultralight Practice Assembly line medicine Low Volume practices in the news --> Housecall MD, Boutique practices my personal real life comparisons OR... How I

saved 26.5 K/month in overhead 2005-current 2000-2002 LOV (Low Overhead Volume) HOV (High Overhead Volume) Self Employed Employee with partnershippotential Part Time Full Time 3 half days/ week 4 full days/ week $130 K/

yr $130 K/ yr (base 110K plusbonus) 10 K / yr OH (overhead) 330K/ yr OH (overhead) <1K mo OH 27.5 K mo OH What does an ultralight overhead look like? My LOV OH (excluding 3K start up expense) recurring expenses in order of

cost rent @ 300/mo 3600/yr Personal health insurance 2200/yr(spouse, me) malpractice 1st yr 1230 (at 50%) Medical supplies 700/yr Phone

cell + land 700/yr Office liability insurance 500/yr Hospital/society Dues 600/yr Office supplies 300/yr

9830= 819/mo Compare % OH (overhead) LOV & HOV models My LOV Revenue 2500-3000/wk = 130K- 156K (call it 130K) % OH/TOTrevenue 9830/130,000 =>> 7.6 % is overhead HOV OH in practice 330K/yr or 27.5K/mo so I brought in 460K/yr with 130K salary % OH/TOT revenue 330K/460

K=>> 71.7% is overhead (MGMA 60% average OH for HOV in 2002) How many days will I have to work to pay my OH? LOV part time to pay overhead at 10K/yr? < 1 month 3.3 weeks @ 3 half days week = 10 half days making $1000 per 1/2 day HOV full time to pay my portion of OH? 8.6 months

37.2 weeks @ 4 full days/wk = 148.8 full days making $2218 per full day How many patients seen per year to pay overhead ?? Pts/wk (at 25/wk) x 3.3 wks to pay part time OH LOV = 83 patients @ $118/pt collected Pts/wk (112/wk) x 37.2 wks to pay full time OH HOV = 4166

patients @ $79.21/pt collected Collection rate AR 30,60, 90 days? LOV no cash collections/bad debt department - all cash pts pay in full at time of service insurance payments received 14-21 day average, no AR 60,90 accounts HOV pts sent to collections, billing dept tracking unpaidaccounts uninsured pts not accepted or cash pts with unpaid balances at visit insurance payments with larger 30,60,90 ARs to track, denials tofollow Lack of data on LOV in medical literature Recruiters, MGMA, medical organizations

give statistics based on HOVpracticesLOV practices were the norm 50 years ago, but most docs are not exposed toLOV data in training, journals or elsewhere and are heavily marketed withHOV"opportunities"So I am open for comments and most appreciative for your thoughts. This isjust the financial portion of my presentation. I like it because it highlights thedifferences in a dramatic real life way. By the way the 130K/yr is extrapolated into thefirst 12 months at capacity at my "LOVe" practice. I reached capacity 2-3 montsh ago and the #shave supported my figures above since. The first 6-8 months were "start-up"months and not typical of the future numbers. Thanks!PamelaPamela Wible, MDFamily & Community Medicine, LLC3575 st. #220 Eugene, OR 97405roxywible@...

[Guest guest]

From your medical supplies of $700/year, I'm guessing you are not doing

vaccines? I'm amazed at what you are making in just 3 half-days a week -

much higher than what I could do in that time frame.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O. Box 7275

Woodland Park, CO 80863

LOV (Low Overhead Volume) vs. HOV (High

Overhead Volume) numbers - VERY INTEREST

Hello all. I am preparing to give a grand rounds presentation in NY state

later next month

to inspire the latest grads in the LOV (Low Overhead Volume) model vs. the

HOV (High

Overhead Volume) model. I guess I LOVE the LOV model! The numbers

crunching I did

today really highlighted the differences in a visceral way for me.

Low Overhead Volume (LOV) vs. High Overhead Volume (HOV)

Ultralight Practice Assembly line medicine

Low Volume practices in the news --> Housecall MD, Boutique practices

my personal real life comparisons

OR... How I saved 26.5 K/month in overhead

2005-current 2000-2002

LOV (Low Overhead Volume) HOV (High Overhead Volume)

Self Employed Employee with partnership

potential

Part Time Full Time

3 half days/ week 4 full days/ week

$130 K/ yr $130 K/ yr (base 110K plus

bonus)

10 K / yr OH (overhead) 330K/ yr OH (overhead)

<1K mo OH 27.5 K mo OH

What does an ultralight overhead look like?

My LOV OH (excluding 3K start up expense) recurring expenses

in order of cost

rent @ 300/mo 3600/yr

Personal health insurance 2200/yr

(spouse, me)

malpractice 1st yr 1230 (at 50%)

Medical supplies 700/yr

Phone cell + land 700/yr

Office liability insurance 500/yr

Hospital/society Dues 600/yr

Office supplies 300/yr

9830

= 819/mo

Compare % OH (overhead) LOV & HOV models

My LOV Revenue 2500-3000/wk = 130K- 156K (call it 130K)

% OH/TOTrevenue 9830/130,000 =>> 7.6 % is overhead

HOV OH in practice 330K/yr or 27.5K/mo

so I brought in 460K/yr with 130K salary

% OH/TOT revenue 330K/460 K=>> 71.7% is overhead

(MGMA 60% average OH for HOV in 2002)

How many days will I have to work to pay my OH?

LOV part time to pay overhead at 10K/yr? < 1 month

3.3 weeks

@ 3 half days week

= 10 half days

making $1000 per 1/2 day

HOV full time to pay my portion of OH? 8.6 months

37.2 weeks

@ 4 full days/wk

= 148.8 full days

making $2218 per full day

How many patients seen per year to pay overhead ??

Pts/wk (at 25/wk) x 3.3 wks to pay part time OH LOV = 83 patients

@ $118/pt collected

Pts/wk (112/wk) x 37.2 wks to pay full time OH HOV = 4166 patients

@ $79.21/pt collected

Collection rate AR 30,60, 90 days?

LOV no cash collections/bad debt department -

all cash pts pay in full at time of service

insurance payments received 14-21 day average, no AR 60,90 accounts

HOV pts sent to collections, billing dept tracking unpaid

accounts

uninsured pts not accepted or cash pts with unpaid balances at visit

insurance payments with larger 30,60,90 ARs to track, denials to

follow

Lack of data on LOV in medical literature

Recruiters, MGMA, medical organizations give statistics based on HOV

practices

LOV practices were the norm 50 years ago, but most docs are not exposed to

LOV data in training, journals or elsewhere and are heavily marketed with

HOV

" opportunities "

So I am open for comments and most appreciative for your thoughts. This is

just the

financial portion of my presentation. I like it because it highlights the

differences in a

dramatic real life way. By the way the 130K/yr is extrapolated into the

first 12 months at

capacity at my " LOVe " practice. I reached capacity 2-3 montsh ago and the #s

have

supported my figures above since. The first 6-8 months were " start-up "

months and not

typical of the future numbers.

Thanks!

Pamela

Pamela Wible, MD

Family & Community Medicine, LLC

3575 st. #220

Eugene, OR 97405

roxywible@...

[Guest guest]

From your medical supplies of $700/year, I'm guessing you are not doing

vaccines? I'm amazed at what you are making in just 3 half-days a week -

much higher than what I could do in that time frame.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O. Box 7275

Woodland Park, CO 80863

LOV (Low Overhead Volume) vs. HOV (High

Overhead Volume) numbers - VERY INTEREST

Hello all. I am preparing to give a grand rounds presentation in NY state

later next month

to inspire the latest grads in the LOV (Low Overhead Volume) model vs. the

HOV (High

Overhead Volume) model. I guess I LOVE the LOV model! The numbers

crunching I did

today really highlighted the differences in a visceral way for me.

Low Overhead Volume (LOV) vs. High Overhead Volume (HOV)

Ultralight Practice Assembly line medicine

Low Volume practices in the news --> Housecall MD, Boutique practices

my personal real life comparisons

OR... How I saved 26.5 K/month in overhead

2005-current 2000-2002

LOV (Low Overhead Volume) HOV (High Overhead Volume)

Self Employed Employee with partnership

potential

Part Time Full Time

3 half days/ week 4 full days/ week

$130 K/ yr $130 K/ yr (base 110K plus

bonus)

10 K / yr OH (overhead) 330K/ yr OH (overhead)

<1K mo OH 27.5 K mo OH

What does an ultralight overhead look like?

My LOV OH (excluding 3K start up expense) recurring expenses

in order of cost

rent @ 300/mo 3600/yr

Personal health insurance 2200/yr

(spouse, me)

malpractice 1st yr 1230 (at 50%)

Medical supplies 700/yr

Phone cell + land 700/yr

Office liability insurance 500/yr

Hospital/society Dues 600/yr

Office supplies 300/yr

9830

= 819/mo

Compare % OH (overhead) LOV & HOV models

My LOV Revenue 2500-3000/wk = 130K- 156K (call it 130K)

% OH/TOTrevenue 9830/130,000 =>> 7.6 % is overhead

HOV OH in practice 330K/yr or 27.5K/mo

so I brought in 460K/yr with 130K salary

% OH/TOT revenue 330K/460 K=>> 71.7% is overhead

(MGMA 60% average OH for HOV in 2002)

How many days will I have to work to pay my OH?

LOV part time to pay overhead at 10K/yr? < 1 month

3.3 weeks

@ 3 half days week

= 10 half days

making $1000 per 1/2 day

HOV full time to pay my portion of OH? 8.6 months

37.2 weeks

@ 4 full days/wk

= 148.8 full days

making $2218 per full day

How many patients seen per year to pay overhead ??

Pts/wk (at 25/wk) x 3.3 wks to pay part time OH LOV = 83 patients

@ $118/pt collected

Pts/wk (112/wk) x 37.2 wks to pay full time OH HOV = 4166 patients

@ $79.21/pt collected

Collection rate AR 30,60, 90 days?

LOV no cash collections/bad debt department -

all cash pts pay in full at time of service

insurance payments received 14-21 day average, no AR 60,90 accounts

HOV pts sent to collections, billing dept tracking unpaid

accounts

uninsured pts not accepted or cash pts with unpaid balances at visit

insurance payments with larger 30,60,90 ARs to track, denials to

follow

Lack of data on LOV in medical literature

Recruiters, MGMA, medical organizations give statistics based on HOV

practices

LOV practices were the norm 50 years ago, but most docs are not exposed to

LOV data in training, journals or elsewhere and are heavily marketed with

HOV

" opportunities "

So I am open for comments and most appreciative for your thoughts. This is

just the

financial portion of my presentation. I like it because it highlights the

differences in a

dramatic real life way. By the way the 130K/yr is extrapolated into the

first 12 months at

capacity at my " LOVe " practice. I reached capacity 2-3 montsh ago and the #s

have

supported my figures above since. The first 6-8 months were " start-up "

months and not

typical of the future numbers.

Thanks!

Pamela

Pamela Wible, MD

Family & Community Medicine, LLC

3575 st. #220

Eugene, OR 97405

roxywible@...

[Guest guest]

Per previous posts, that is because she is getting paid upwards of $175 for

a 99214 where she works! That makes it quite a bit easier to do.

LOV (Low Overhead Volume) vs. HOV (High

Overhead Volume) numbers - VERY INTEREST

Hello all. I am preparing to give a grand rounds presentation in NY state

later next month

to inspire the latest grads in the LOV (Low Overhead Volume) model vs. the

HOV (High

Overhead Volume) model. I guess I LOVE the LOV model! The numbers

crunching I did

today really highlighted the differences in a visceral way for me.

Low Overhead Volume (LOV) vs. High Overhead Volume (HOV)

Ultralight Practice Assembly line medicine

Low Volume practices in the news --> Housecall MD, Boutique practices

my personal real life comparisons

OR... How I saved 26.5 K/month in overhead

2005-current 2000-2002

LOV (Low Overhead Volume) HOV (High Overhead Volume)

Self Employed Employee with partnership

potential

Part Time Full Time

3 half days/ week 4 full days/ week

$130 K/ yr $130 K/ yr (base 110K plus

bonus)

10 K / yr OH (overhead) 330K/ yr OH (overhead)

<1K mo OH 27.5 K mo OH

What does an ultralight overhead look like?

My LOV OH (excluding 3K start up expense) recurring expenses

in order of cost

rent @ 300/mo 3600/yr

Personal health insurance 2200/yr

(spouse, me)

malpractice 1st yr 1230 (at 50%)

Medical supplies 700/yr

Phone cell + land 700/yr

Office liability insurance 500/yr

Hospital/society Dues 600/yr

Office supplies 300/yr

9830

= 819/mo

Compare % OH (overhead) LOV & HOV models

My LOV Revenue 2500-3000/wk = 130K- 156K (call it 130K)

% OH/TOTrevenue 9830/130,000 =>> 7.6 % is overhead

HOV OH in practice 330K/yr or 27.5K/mo

so I brought in 460K/yr with 130K salary

% OH/TOT revenue 330K/460 K=>> 71.7% is overhead

(MGMA 60% average OH for HOV in 2002)

How many days will I have to work to pay my OH?

LOV part time to pay overhead at 10K/yr? < 1 month

3.3 weeks

@ 3 half days week

= 10 half days

making $1000 per 1/2 day

HOV full time to pay my portion of OH? 8.6 months

37.2 weeks

@ 4 full days/wk

= 148.8 full days

making $2218 per full day

How many patients seen per year to pay overhead ??

Pts/wk (at 25/wk) x 3.3 wks to pay part time OH LOV = 83 patients

@ $118/pt collected

Pts/wk (112/wk) x 37.2 wks to pay full time OH HOV = 4166 patients

@ $79.21/pt collected

Collection rate AR 30,60, 90 days?

LOV no cash collections/bad debt department -

all cash pts pay in full at time of service

insurance payments received 14-21 day average, no AR 60,90 accounts

HOV pts sent to collections, billing dept tracking unpaid

accounts

uninsured pts not accepted or cash pts with unpaid balances at visit

insurance payments with larger 30,60,90 ARs to track, denials to

follow

Lack of data on LOV in medical literature

Recruiters, MGMA, medical organizations give statistics based on HOV

practices

LOV practices were the norm 50 years ago, but most docs are not exposed to

LOV data in training, journals or elsewhere and are heavily marketed with

HOV

" opportunities "

So I am open for comments and most appreciative for your thoughts. This is

just the

financial portion of my presentation. I like it because it highlights the

differences in a

dramatic real life way. By the way the 130K/yr is extrapolated into the

first 12 months at

capacity at my " LOVe " practice. I reached capacity 2-3 montsh ago and the #s

have

supported my figures above since. The first 6-8 months were " start-up "

months and not

typical of the future numbers.

Thanks!

Pamela

Pamela Wible, MD

Family & Community Medicine, LLC

3575 st. #220

Eugene, OR 97405

roxywible@...