The choice between purchasing a nuclear camera or using a mobile service is an important decision for your practice. There is a broad range of factors that shape the decision, and following a “cookie cutter” formula is not recommended. Understanding the unique dynamics at work in your practice can shed light on which choice is best for you and your patients. Let’s explore some key data points to review:
Study volume is an important metric when considering purchasing a nuclear camera vs. contracting with a mobile provider. On the low end, 60 studies per month could technically support camera ownership, but a monthly average of 120 is a more sustainable number. Below 100 studies per month becomes financially challenging and requires temporary staffing and other hybrid approaches to make the best of things. Another way to evaluate the volume question is on the number of days in the week in which you scan. Practices that prefer imaging less studies per day and more days per week will find a need for creativity in managing their non-equipment costs in order to achieve reasonable profitability from their Nuclear Lab.
Established practice vs. start-up
Often, your prior experience can be a contributing factor in the decision. If you’ve owned a camera in the past and understand the requirements, it’s easier to know if ownership is a right fit. If you are starting up a practice, you could initially opt for a mobile service to get a better feel for your study volume before making a major purchasing decision. Given all of the various start-up expenses, including needing cash in the bank to fund the lag between your open day and cash flow back from the various payors, whether or not you want to tie up cash or credit resources for a major purchase is a critical decision point. Physicians who open a smaller 1 to 4 provider practice, versus a multi-physician practice, often choose mobile services over ownership for the similar reasons.
The value of the unknown
One major factor that complicates the decision is clarity on the actual cost burden or potential profitability when purchasing a camera. Because mobile services typically use per-day or other similar billing options, your financial risk is very low, and the practice has a very clear understanding of profit overall, and per day of service. Since camera costs (lease payment or depreciation plus repair and maintenance) are not the highest cost drivers, thinking that ownership is more profitable than a service is not a given. With pending insurance reimbursement changes, new payment models on the horizon, and the reality of appropriate use criteria, it’s difficult to know the exact financial return you can achieve from a camera purchase.
The question of how to provide imaging services touches on a full spectrum of factors including revenue, profitability, patient convenience, market perception, practice size, and patient satisfaction. The final decision is shaped by your study volume and how established your patient base is, but ultimately it comes down to how comfortable you are with the requirements of running a nuclear lab and your willingness to invest the time and energy into managing on your own.