The Cost of Care During Times of COVID: Case Study of TDABC and Minimum Utilization Cost Analysis in a Medicare Advantage Population

Authors

  • Alberto Jacir, M.D., MBA Assistant Professor and Vice Chair Department of Family Medicine and Community Health Miller School of Medicine University of Miami Health System
  • Damaris Mendoza, RN, M.H.A. UHealth Business Development and Managed Care University of Miami Health System
  • Emma Dean, Ph.D. Director Business Operations, Population Health UHealth Business Development and Managed Care University of Miami Health System
  • Howard Gitlow, Ph.D. Professor, Management Science Six Sigma Master Black Belt Miami Herbert School of Business University of Miami

Abstract

The COVID-19 pandemic has obligated us to rethink the use of telemedicine in healthcare.  During Covid-19 telemedicine has been essential to maintain patient access and provide continuity of care.  Historically, cost calculations in healthcare have not been transparent and accurate enough to project cost-effective strategies. This is particularly relevant when attempting to use value-based costing.  The Medicare Advantage Care service model offers great opportunity to evaluate the cost of care for research and financial reasons. Based on a capitated reimbursement model, a TDABC (Time Driven Activity Based Costing) methodology provides an accurate analysis to determine a MUC (Minimum Utilization Cost), contributing to better alignment and projection of an MLR (Medical Loss Ratio) that helps keep the balance between quality of care and financial responsibility.

PUBLISHER'S NOTE:  I had the pleasure of interviewing two of the authors about this subject matter.

Author Biographies

  • Alberto Jacir, M.D., MBA, Assistant Professor and Vice Chair Department of Family Medicine and Community Health Miller School of Medicine University of Miami Health System

    Assistant Professor and Vice Chair Department of Family Medicine and Community Health
    Miller School of Medicine
    University of Miami Health System

  • Damaris Mendoza, RN, M.H.A., UHealth Business Development and Managed Care University of Miami Health System

    UHealth Business Development and Managed Care
    University of Miami Health System

  • Emma Dean, Ph.D., Director Business Operations, Population Health UHealth Business Development and Managed Care University of Miami Health System

    Director Business Operations, Population Health
    UHealth Business Development and Managed Care
    University of Miami Health System

  • Howard Gitlow, Ph.D., Professor, Management Science Six Sigma Master Black Belt Miami Herbert School of Business University of Miami

    Professor, Management Science
    Six Sigma Master Black Belt
    Miami Herbert School of Business
    University of Miami

References

Please see the article for references.

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Published

2021-08-04