Is Treating Oral & Maxillofacial Trauma Profitable? An Analysis of Hospital and Surgeon Reimbursement at an Academic Medical Center

Publication date: Available online 6 October 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Dean M. DeLuke, Vickas Agarwal, Trevor Holleman, Caroline K. Carrico, Daniel M. Laskin
PurposeOver the past two decades there has been a marked decrease in the willingness of community-based oral and maxillofacial surgeons to participate in trauma call. While many factors may influence the decision not to take trauma call, one primary disincentive is the perception that managing facial trauma may be profitable for the hospital, but is not profitable for the surgeon. The purpose of this study was to compare the profitability of facial trauma management for the hospital and the surgeon at the VCU Medical Center.Materials and MethodsIn this retrospective cohort study, records were collected for patients who were seen for primary trauma management by the Department of Oral and Maxillofacial Surgery (OMS) between June 2011 and July 2014. Cost and reimbursement data were analyzed for these patients from both the VCU Health System (VCUHS) and the VCU Department of OMS. For the hospital, actual cost data was provided, and for the surgeon it was calculated based on an average overhead of 50 percent. For uniformity, patients were excluded if they remained in the hospital for more than a 23-hour observation period. Patients under the age of 18 were also excluded.ResultsA total of 169 patients met the inclusion criteria. There was a statistically significant difference in both the percent of costs recouped and the actual profit. The average percent of costs recouped was 230% for the VCUHS, while OMS only recouped 47% of costs.This amounts to an average profit per case of $3461 for the hospital versus a loss of $1162 for the surgeon.ConclusionsThe results of this study indicate that in our medical center, maxillofacial trauma yields a net profit for the hospital and a net loss for the operating surgeon. While the results are limited to outpatient management at one academic institution, they suggest that hospitals in some settings may be in a position to incentivize surgeons for trauma management.



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