McCue Michael J, Palsbo Susan E
Department of Health Administration, Virginia Commonwealth University, Richmond, VA 23298, USA.
Telemed J E Health. 2006 Apr;12(2):99-106. doi: 10.1089/tmj.2006.12.99.
The objective of this study was to demonstrate the business case for telemedicine in nonrural areas. We developed an interactive spreadsheet to conduct multiple financial analyses under different capital investment, revenue, and expense scenarios. We applied the spreadsheet to the specific case of poststroke rehabilitation in urban settings. The setting involved outpatient clinics associated with a freestanding rehabilitation hospital in Oklahoma. Our baseline scenario used historical financial data from face-to-face encounters as the baseline for payer and volume mix. We assumed a cost of capital of 10% to finance the project. The outcome measures were financial breakeven points and internal rate of return. A total of 340 telemedicine visits will generate a positive net cash flow each year. The project is expected to recoup the initial investment by the fourth year, produce a positive present value dollar return of more than $2,000, and earn rate of return of 20%, which exceeds the hospital's cost of capital. The business case is demonstrated for this scenario. Urban telemedicine programs can be financially self-sustaining without accounting for reductions in travel time by providers or patients. Urban telemedicine programs can be a sound business investment and not depend on grants or subsidies for start-up funding. There are several key decision points that affect breakeven points and return on investment. The best business strategy is to approach the decision as whether or not to build a new clinic.
本研究的目的是证明远程医疗在非农村地区的商业案例。我们开发了一个交互式电子表格，以在不同的资本投资、收入和支出场景下进行多项财务分析。我们将该电子表格应用于城市环境中中风后康复的具体案例。该场景涉及俄克拉荷马州一家独立康复医院的门诊诊所。我们的基线场景使用面对面诊疗的历史财务数据作为支付方和服务量组合的基线。我们假设为该项目融资的资本成本为10%。结果指标是财务盈亏平衡点和内部收益率。每年总共340次远程医疗诊疗将产生正的净现金流。预计该项目到第四年将收回初始投资，产生超过2000美元的正现值美元回报，并获得20%的回报率，超过医院的资本成本。此场景的商业案例得到了证明。城市远程医疗项目在不考虑提供者或患者出行时间减少的情况下，在财务上可以实现自我维持。城市远程医疗项目可以是一项合理的商业投资，不依赖赠款或补贴作为启动资金。有几个关键决策点会影响盈亏平衡点和投资回报率。最佳商业策略是将决策视为是否建造一家新诊所。
