The following calculator estimates the net annual impact of integrating the Multifunction Cardiogram into hospital emergency room settings. To utilize the calculator, simply enter the total number of patients presenting to your emergency room each year into the first input field, and hit the ‘enter’ key on your keyboard. Alternatively, if you would like to adjust some of the calculator assumptions, click on the “Fine Tune Calculator Settings” first.
The total estimated financial impact on your hospital will be presented in the bottom row, with a line-by-line cited explanation of how those impacts were estimated provided in the following section.
Calculator Inputs
| Number of annual Emergency Room patients for your organization: | ←Type your input here and hit 'enter' to calculate! | ||||
| A | Number of annual Emergency Room patients for your organization presenting with chest pain (16.2% U.S. average): | ||||
| F | Your organization's admission revenue from new ischemia patient admissions and treatment: | $ | |||
| G | Your organization's low risk patient cost avoidance, per patient successfully discharged: | $ | |||
Emergency Room Patient Ischemia Categories
| Patient Statistics | Financial Impact | ||||
|---|---|---|---|---|---|
| A | Number of patients presenting with chest pain or other cardiac issues (16.2% of all emergency room patients): | 9,720 | → | Cost of performing MCG tests on all emergency room patients assuming zero reimbursement (under $300 per patient/test): | -$2,673,000 |
| B | Take away the patients actually having an MI (5-10% * 9,720): | -972 | |||
| C | Take away the additional patients easily ruled out for other presentations (20-25% * 9,720): | -2,430 | |||
| D | Leaving a total number of patients who need further evaluation: | 5,832 | |||
Calculated Financial Impacts
| Patient Statistics | Financial Impact | ||||
|---|---|---|---|---|---|
| E | A typical hospital's current technology and protocols meet CMS standards for admission or discharge 33% of the time (about 33% * 5,832): | 1,980 | → | Current discharge activity (status quo): | 0 |
| F | EMCG will find and enable admissions with MCG score >4 (about 30% * 5,832): | 1,925 | → | New admissions revenue ($4,500 per patient): | 7,874,200 |
| G | EMCG will enable discharge to home patients with MCG score <2 (about 37% * 5,832): | 2,158 | → | Discharge cost avoidance ($1,500 per patient): | 3,236,760 |
| Total bottom line annual impact attributable to MCG: | 8,437,960 | ||||
Calculator Notes and References
| A | Based on 2011 data by the US CDC (Table 26), approximately 16.2% of all US emergency room visits are related to chest pain, ischemia, cardiac, and syncope symptoms. It costs under $300 per MCG test per patient per day. |
| B | Only 10 to 20 percent of patients (15% on average) admitted to the hospital with chest pain are actually diagnosed with myocardial infarction during their stay. See Evaluation of the Patient with Acute Chest Pain (2005). |
| C | Optimistically, 10-20% of patients presenting with chest pain can be correctly discharged due to easily observed presentations and symptoms that disqualify ischemic causes, although anecdotal data from our clinical trial partners implies that actual percentages are lower. Please note that while these patients may be experiencing chest pain for non-ischemic symptoms, they may still have an ischemic burden. |
| E | Optimistically, 30-35% of low-risk patients presenting with chest pain can be correctly identified with existing (non-MCG) methods without extended observation, although anecdotal data from our clinical trial partners implies that actual percentages are lower. |
| F | Patients exhibiting MCG scores of 4+ demonstrate intermediate myocardia ischemia burdens, simultaneous fluctuating myocardial ischemia patterns represented by either local, global myocardial ischemia, or occasional myocardial ischemia altogether absent in the same session. MCG clinical trial data show that approximately 30% of chest pain patients without immediately ruled-out symptoms fall into this category; these are patients who might be discharged but should be treated. Published data show that the revenue to US hospitals for new admissions of patients receiving necessary cardiac care represents fees of $4,200 to $7,597 (see Identifying patient risk: The basis for rational discharge planning after acute myocardial infarction); discussions with MCG participating hospitals indicate that a revenue figure of $4,500 per new cardiac patient is conservative. |
| G | Patients exhibiting MCG scores of 2 or lower have a low myocardial ischemic burden and are considered “low risk.” Based on CDC data and the experience of our clinical trial partners, these patients represent approximately 35.8% of patients presenting with chest pain (5.8% of 16.2% of ED visits). The discharge cost avoidance experienced by hospitals by correctly discharging low ischemic risk patients ranges from $1,572 (VCU Medical Center) to $2,000 (A Report from the Short Term Observation Services) and higher, as reported by our clinical research partners. |
Financial Impacts Not Included in Calculator
- 2-5% of patients experiencing acute myocardial infarction are sent home as asymptomatic but represent a high risk for out-of-hospital MACE events and constitute 25% of all emergency care malpractice dollars awarded in litigation.
- A significant portion of hospital charges for observation and treatment of patients who did not experience a MACE event within 30 days result in RAC audit penalties; this is, in fact, the highest category of hospital RAC audit penalties, and federal regulators are currently pursuing $37 billion in RAC penalties against US hospitals for “improper” cardiac observation charges. Costs include penalties, staff and legal time, processing of appeals, and funds held in reserve.
Disclaimer
While this calculator is built upon the best data available to us at the time of publication, we can make no guarantee as to the accuracy of any estimates produced by the calculator. Emergency MCG Inc. makes no guarantee or assurance regarding the actual financial impacts of the Multifunction Cardiogram. This calculator is provided for educational purposes only; please use it at your own risk.