The Productivity Requirements Of Implementing A Medical Scribe Program

Objective: To determine the number of additional patient visits various specialties would need to recover the costs of implementing scribes in their practice at 1 year.Design: Modeling study based on 2015 data from the Centers for Medicare & Medicaid Services (CMS) and National Ambulatory Medical Care Survey. Scribe costs were based on literature review and a third-party contractor model. Revenue was calculated from direct visit billing, CPT (Current Procedural Terminology) billing, and data from the National Ambulatory Medical Care Survey.Data Sources: 2015 data from CMS and the National Ambulatory Medical Care Survey.Target Population: Health care providers.Time Horizon: 1 year.Perspective: Office-based clinic.Outcome Measures: The number of additional patient visits a physician must have to recover the costs of a scribe program at 1 year.Results of Base-Case Analysis: An average of 1.34 additional new patient visits per day (295 per year) were required to re-cover scribe costs (range, 0.89 [cardiology] to 1.80 [orthopedic surgery] new patient visits per day). For returning patients, an average of 2.15 additional visits per day (472 per year) were required (range, 1.65 [cardiology] to 2.78 [orthopedic surgery] returning visits per day). The addition of 2 new patient (or 3 returning) visits per day was profitable for all specialties.Results of Sensitivity Analysis: Results were not sensitive to most inputs, with the exception of hourly scribe cost and inclusion of CPT revenue.Limitation: Use of Medicare data and failure to account for indirect costs, downstream revenue, or changes in documentation quality.Conclusion: For all specialties, modest increases in productivity due to scribes may allow physicians to see more patients and offset scribe costs, making scribe programs revenue-neutral.