Date of Award

9-30-2010

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Dr. David Leffell,

Second Advisor

Dr. Robert Tigelaar

Abstract

This project was aimed at defining, quantifying and analyzing the value of uncompensated care provided by physicians as part of the Yale Medical Group for the 2008 fiscal year. Using an opportunity cost model, uncompensated care was calculated for each department as a total of bad debt and free care and then compared to existing estimates of such care. Another aim of this study was to conduct an interdepartmental comparison of the value of such care as a percentage of departmental earnings. To undertake this study, a literature search was performed to determine previous estimates and models of uncompensated care by physicians. Primary financial data (including charges, payments and write-offs for Bad Debt and Free Care) from the Yale Medical Group for fiscal year 2008 was then collected, fed into the opportunity cost model and compared to published estimates. The results of this study showed that, as a whole, physicians at the Yale Medical Group provided $6,510,373.65 of Uncompensated Care (or 2.75% of Total Payments) with a departmental range of 0.57%-15.29% of Total payments. These results show that Faculty physicians at Yale provided a larger amount of Uncompensated care than the published estimates obtained from random sampling of almost 4000 physicians. The results also reveal large differences in levels of uncompensated care between departments at Yale.

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