The financial case for virtual specialty care runs on two entirely different mechanisms depending on how the hospital is paid. Select a designation. The model changes, not just the numbers.
Hospital profile
Inpatient transfers out in the covered specialties.
76
Rural network median is 76 miles.
Three or more is the high-engagement threshold.
62%
Drives the case-mix calculation on IPPS only.
Modeled annual value
Net annual value
—
after platform cost
Return
—
—
Cases retained
—
—
Value component
Annual
Assumptions and parameters
Medicare pays 101% of this. Margin is the 1%.
Imaging, lab, follow-up and specialty visits that follow a transferred patient to the receiving system. Requires local validation.
15%
CAH only. Retained patients transitioning to swing-bed post-acute care.
Default assumes $180 net across 5 days.
Natafgi et al. 2018. Reported as a memo line. It is not hospital margin.