Unit 3: Finances
Unit 5. Finances

Section 1. Financial Viability

Revenue

The following table is a static reproduction of the revenue tab from the interactive budget-planning workbook. This version was developed based on a set of assumptions, indicated by the numbers entered in the shaded cells.

Download the Excel file so that you can change the numbers, as necessary, to estimate revenue for your clinic.

Interactive Budget-Planning Workbook—Revenue
(This table is static, the downloadable workbook is interactive.)

REVENUE
Insert program-specific estimates in highlighted cells
   
I. Patient-Care Revenue—estimated number of encounters/year 4,940              
Fee-for-service  % of encounters # of encounters Avg charge/ encounter Total charges
Average adjustment/ encounter
Total charge reductions
Adjusted charge/  encounter Amount billed
Medicaid 45% 2,223 $285 $633,555 $30 $66,690 $172 $382,356
CHIP 8% 395 $285 $112,632 $100 $39,520 $185 $73,112
Public and private-nonprofit program contracts 4% 198 $285 $56,316 $140 $27,664 $145 $28,652
Self-Pay
   Full 3% 148 $285 $42,237 $-   $-   $285 $42,237
   Sliding fee schedule 11% 543 $285 $154,869 $200 $108,680 $85 $46,189
   Minimum 15% 741 $285 $211,185 $240 $177,840 $45 $33,345
Commercial insurance                 
   Indemnity (fee-for-service) 5% 247 $285 $70,395 $-   $-   $285 $70,395
   Managed Care - PPO 3% 148 $285 $42,237 $65 $9,633 $220 $32,604
Fee-for-servic patient-care revenue subtotal       $1,323,426   $430,027   $708,890
Medicaid prospective payment or cost-based (fee/encounter) 0% 0           $0
Capitation/Managed Care (HMO) - (List individual numbers and capitation rates if multiple contracts, whether commercial or Medicaid HMOs)   # of patients Capitation rate Total charges
Adjustment per patient Total charge reductions
$/patient/yr  
Dental plan 6% 296 360 $106,704 180 53,230 $180 $53,352
    0           $0
    0           $0
    0           $0
Capitation Patient-Care Revenue Subtotal $53,352
PATIENT-CARE REVENUE TOTAL $762,242
 
II. Non-Patient-Care Revenue Sources
A. Grants and contracts
   Federal $100,000
   State $50,000
   City/County $20,000
   Foundation(s) $75,000
   Other  
Grants and contracts subtotal $245,000
B. Fundraising
   Individual donations $10,000
   Corporate donations $19,000
   Events $7,500
   Other  
Fundraising Subtotal $36,500
NON-PATIENT-CARE REVENUE TOTAL $281,500
REVENUE (ALL SOURCES) $1,043,742