THE COST OF PERFORMING FEES: ESTIMATING ANNUALIZED COSTS OF MOBILE FEES PROVIDERS FOR LTACH AND SNFS
Author(s)
Ian K. Haislip, MPH, Christina Cool, MPH.
Health Economics, Outcomes Research & Market Access, AMBU USA, Columbia, MD, USA.
Health Economics, Outcomes Research & Market Access, AMBU USA, Columbia, MD, USA.
OBJECTIVES: Flexible endoscopic evaluation of swallowing (FEES) is an integral diagnostic procedure used to assess and diagnose swallowing disorders. Endoscopy equipment and a trained speech-language pathologist (SLP) required for FEES exams are often unavailable in long-term acute care hospitals (LTACHs) and skilled nursing facilities (SNFs). Facilities may rely on third-party mobile FEES providers or a separate facility when FEES cannot be performed in-house. This study estimated the annual cost of third-party mobile FEES providers across varying procedure volumes in LTACH and SNF settings.
METHODS: Third-party mobile providers’ cost data and annual volumes were obtained from a national survey of 205 LTACH and SNF healthcare professionals with facility decision-making authority. A model was created to estimate the annual costs of third-party providers using average procedure volumes and costs from the survey. A sensitivity analysis evaluated cost differences with varying FEES volume and provider inputs.
RESULTS: Previously published survey results showed mobile provider costs ranging from $301 to $800 per exam (47% $301-$500, 35% $501-$800), with 78% of respondents performing more than 150 FEES annually. The model estimated annual third-party FEES costs using per-exam costs of $301, $500 and $800. At 150 exams annually, the total costs amounted to $45,150, $75,000, and $120,000, respectively. At 300 exams, costs increased to $90,300, $150,000, and $240,000. At the highest FEES volume modeled (500 annually), the total estimated annual costs amounted to $150,500, $250,000 and $400,000, respectively.
CONCLUSIONS: For LTACHs and SNFs that do not have the appropriate equipment and trained staff readily available for FEES exams, utilizing third-party providers is a common alternative that can be costly across a range of procedural volumes. Additionally, facility administrators noted incurring cancellation and rescheduling fees on top of the exam charges, which would increase the total annual costs incurred for these services.
METHODS: Third-party mobile providers’ cost data and annual volumes were obtained from a national survey of 205 LTACH and SNF healthcare professionals with facility decision-making authority. A model was created to estimate the annual costs of third-party providers using average procedure volumes and costs from the survey. A sensitivity analysis evaluated cost differences with varying FEES volume and provider inputs.
RESULTS: Previously published survey results showed mobile provider costs ranging from $301 to $800 per exam (47% $301-$500, 35% $501-$800), with 78% of respondents performing more than 150 FEES annually. The model estimated annual third-party FEES costs using per-exam costs of $301, $500 and $800. At 150 exams annually, the total costs amounted to $45,150, $75,000, and $120,000, respectively. At 300 exams, costs increased to $90,300, $150,000, and $240,000. At the highest FEES volume modeled (500 annually), the total estimated annual costs amounted to $150,500, $250,000 and $400,000, respectively.
CONCLUSIONS: For LTACHs and SNFs that do not have the appropriate equipment and trained staff readily available for FEES exams, utilizing third-party providers is a common alternative that can be costly across a range of procedural volumes. Additionally, facility administrators noted incurring cancellation and rescheduling fees on top of the exam charges, which would increase the total annual costs incurred for these services.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE96
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas