Economic Aspects of Head and Neck Oncologic Surgery: Implications for the Head and Neck Surgeon Now and in the Future

Abstract

Program Description: Although head and neck oncologic surgery (HNOS) is time consuming, requires an effective team, and needs allotment of precious resources, financial compensation for the surgeon is relatively low so that financial inducements for a surgeon to do HNOS are diminishing. However, HNOS can generate significant revenue for a hospital. This miniseminar provides information about costs, revenue, profit/ loss analysis of many aspects of HNOS. Parameters pertaining to HNOS that will be defined and discussed include the following: relative value units (RVU’s) contribution margins, case mix index, allocated expenses, opportunity costs, comparative profitability of various different treatment modalities, and the impact of diminishing reimbursements. In addition we will explain the ways that an otolaryngology department can utilize hospital financial data to justify the commitment of the varied resources that are needed to do major HNOS cases and to safely take care of the patients following surgery. In addition, we will discuss the mandate from the Residency Review Committee that requires residency programs to provide experience for residents with HNOS index cases. We will discuss how to prepare financial data, economic projections, and a business plan in a way that is both comprehensible to hospital financial planners and sufficiently compelling to warrant the commitment of resources that is likely to enable a HNOS program to become vibrant and grow. Examples of successful efforts to garner hospital resources for HNOS will be provided. Risk management will be considered in an analysis of safety issues inherent in doing HNOS and providing postoperative care for patients with advanced disease. We will discuss the need to report outcome data to such external data repositories and agencies such as University Healthsystems Consortium (UHC), Consumer Assessment of Healthcare Providers and Systems (CAHPS), and the US Department of Health and Human Services. Finally, we will discuss how imminent health care reform measures are likely to impact financial aspects of doing HNOS within the next few years including Accountable Care organizations and Health Innovation Zones. Educational Objectives: 1) Understand how to obtain and interpret hospital financial data that is pertinent for HNOS. 2) Discuss how imminent health care reform measures may impact financial aspects of doing HNOS. 3) Understand the constraints for academic success for a head and neck oncologic surgeon.