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Understanding the Economic Impact of Introducing a New ProcedureEconomic Impact of Endobronchial Ultrasound: Calculating Downstream Revenue of Endobronchial Ultrasound With Transbronchial Needle Aspiration as a Model

Nicholas J. Pastis, MD, FCCP; Suzanne Simkovich, MPAcc; Gerard A. Silvestri, MD, FCCP
Author and Funding Information

From the Division of Pulmonary and Critical Care, Medical University of South Carolina, Charleston, SC.

Correspondence to: Gerard A. Silvestri, MD, FCCP, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 630, Charleston, SC 29425-6300; e-mail: silvestri@musc.edu


For editorial comment see page 288

Funding/Support: This study was supported by an unrestricted grant from Olympus, Inc.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(2):506-512. doi:10.1378/chest.11-0254
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Over the last decade, endobronchial ultrasound (EBUS) evolved into a validated and powerful diagnostic tool. Although it is integral to medical care in some health-care systems, others struggle to justify its purchase based on diminishing reimbursement. In analyzing its value to a health-care system, looking at procedural reimbursement alone will grossly underestimate its economic impact. Downstream revenue has been defined by administrators as revenue captured after patients use one hospital service and then use others. By analyzing consecutive EBUS cases and taking downstream revenue into account, $2.4 million in collections was attributed to 97 patients who were newly referred for this procedure.

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