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The financial contribution of the multiple sclerosis specialist.

ABSTRACT: To examine the financial effect of the multiple sclerosis (MS) specialist on the academic health center (AHC).Using data derived from an academic MS center with respect to patient numbers and practice pattern regarding diagnostic studies and disease-modifying therapies (DMT) coupled with reasonable assumptions regarding the profit margin for tests and treatments, 1 full-time MS specialist (1 clinical full-time equivalent [cFTE]) may annually generate downstream revenue exceeding $8,000,000. If all diagnostic studies and therapies were obtained at the facility, the potential revenue generated for the facility can exceed $25,000,000 per 1 cFTE. These calculations do not include the professional net revenue generated by referrals to other professionals.With current models of reimbursement for health care, the MS specialist provides an enormous potential source of revenue for the AHC. This information is critically important in obtaining institutional support for the provision of labor-intensive MS care.

SUBMITTER: Berger JR

PROVIDER: S-EPMC6081969 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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The financial contribution of the multiple sclerosis specialist.

Berger Joseph R JR

Neurology. Clinical practice 20170601 3

<h4>Purpose of review</h4>To examine the financial effect of the multiple sclerosis (MS) specialist on the academic health center (AHC).<h4>Recent findings</h4>Using data derived from an academic MS center with respect to patient numbers and practice pattern regarding diagnostic studies and disease-modifying therapies (DMT) coupled with reasonable assumptions regarding the profit margin for tests and treatments, 1 full-time MS specialist (1 clinical full-time equivalent [cFTE]) may annually gene ...[more]

PMID: 30107024

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Project description:Next to the disseminated clinical symptoms, cognitive dysfunctions are common features of multiple sclerosis (MS). Over the recent years several different MRI measures became available representing the various features of the pathology, but the contribution to various clinical and cognitive functions is not yet fully understood. In this multiparametric MRI study we set out to identify the set of parameters that best predict the clinical and cognitive disability in MS. High resolution T1 weighted structural and high angular resolution diffusion MRI images were measured in 53 patients with relapsing remitting MS and 53 healthy controls. Clinical disability was inflicted by EDSS and cognitive functions were evaluated with the BICAMS tests. The contribution of lesion load, partial brain, white matter, gray matter and subcortical volumes as well as the diffusion parameters in the area of the lesions and the normal appearing white matter were examined by model free, partial least square (PLS) approach. Significance of the predictors was tested with Variable Importance in the Projection (VIP) score and 1 was used for threshold of significance. The PLS analysis indicated that the axial diffusivity of the NAWM contributed the most to the clinical disability (VIP score: 1.979). For the visuo-spatial working memory the most critical contributor was the size of the bilateral hippocampi (VIP scores: 1.183 and 1.2 left and right respectively). For the verbal memory the best predictors were the size of the right hippocampus (VIP score: 1.972), lesion load (VIP score: 1.274) and the partial brain volume (VIP score: 1.119). In case of the information processing speed the most significant contribution was from the diffusion parameters (fractional anisotropy, mean and radial diffusivity, VIP scores: 1.615, 1.321 respectively) of the normal appearing white matter. Our results indicate that various MRI measurable factors of MS pathology contribute differently to clinical and cognitive disability. These results point out the importance of the volumetry of the subcortical structures and the diffusion measures of the white matter in understanding the disability progression.

Dataset Information

The financial contribution of the multiple sclerosis specialist.

Publications

The financial contribution of the multiple sclerosis specialist.

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