Primary Care Team Cost Calculator

The calculator tool is still in development and testing. Usable outputs may change with future versions.

This Primary Care Team Cost Calculator helps payors and healthcare leaders understand the financial consequences of switching from the current primary care provider team to a proactive team.

How to Use

Note: All inputs are prepopulated with defaults

1. Specify teams and panel sizes: The target panel sizes for the current and proactive team and the type and FTE of support personnel on each team

2. Anticipate offsets: The expected percent reduction in hospital and emergency department (ED) spending due to the improved care of the alternative team

3. Describe patient severity:

a. Patient age mix

OR

b. Average monthly hospital and ED spending, if known

4. Optionally, provide additional financial information for a more specific calculation

More detailed information about each step can be found in the calculator.

Results Provided

• Capitation rates: Primary care capitation rate for both teams, per member-month

• Hospital spending: Expected hospital/ED spend for both teams, per member-month

• Break-even analysis: How large the offset has to be, or how much the panel size has to change, for the for the alternative team’s total cost to equal the team’s total cost. Includes a graph showing the combination or panel sizes and offsets resulting in zero cost change.