Cost Benefit Analysis of Sports Medicine Team Coverage: Is It Worth Our While?

OBJECTIVES: Coverage of high school athletic football by orthopaedic sports medicine specialists is considered standard of care in many localities. Taking time away from an orthopaedic practice to provide on field athletic care has potential advantages and disadvantages. Determining the economic viability of this endeavor has never been investigated. The purpose of the present investigation was to perform a cost/benefit risk analysis of local high school sports coverage by an orthopaedic sports medicine practice. METHODS: From January 2010 to June 2012, a prospective injury report database was used to collect sports injuries from five high school athletic programs covered by a single orthopaedic sports medicine practice. Patients referred for orthopaedic care were then tracked to determine ultimate cost of care (potential revenue). Evaluation and management codes and current procedure terminology codes were obtained to determine the value of physician visits and surgical care rendered using standardized Medicare reimbursement rates. Total values were also analyzed in respect to visits and surgical treatments for the covering practice during this time period. Direct costs were estimated based on physician time required for team coverage and hourly reimbursement rates for orthopaedic surgeons, based on previously reported hourly reimbursement rates. RESULTS: 19,165 athletic trainer evaluations resulted in 473 (2.5%) physician referrals. 185 (39%) of these referrals were to an orthopaedic surgeon. Of the physician referrals, 26 (5.4%) required orthopaedic surgical treatment. The covering team practice handled 89/185 (48%) of the orthopaedic referrals, and handled 17/26 (65%) of the patients that required surgical treatment. The total cost of orthopaedic care for the athletes requiring treatment was $44,239.94 (total potential revenue). The total revenue collected by the covering team practice was $26,226.14 (actual revenue). The cost of a covering team physician for the required hours of coverage was $12,627.81 (overhead). Overall profit of orthopaedic visits and treatment during this period for the covering practice was $13,598.33 (actual revenue - overhead). Total possible profit during the treatment period was $31,612.13 (total potential revenue - overhead). Based on actual revenue collections, the hourly wage of the sports medicine surgeon was calculated to be $116.24. CONCLUSION: A potentially profitable and personally beneficial engagement with local athletes can lead to a symbiotic relationship between physicians and their local communities. The covering team practice handled 48% of the orthopaedic referrals, 65% of the surgical cases, and captured 43% of the potential profit. The hourly rate of reimbursement calculated based on this revenue for the covering team physician is only slightly higher to that found in a prior study.