2021-2022 Client ROI Data
In an effort to continually find quantitative ways to value the work of Athletic Trainers (ATs), we lean heavily on documented encounters throughout the year to generate a return on investment (ROI) for our school district clients. We use InjureFree as our primary injury documentation software, where an incident that requires a change in playing status is recorded. In an attempt to capture all other interactions, we utilize a google sheet where ATs tally total interactions by type each week (see below for sample interaction types).
Each year this data is then downloaded, de-identified, and sent to AT Efficiency. It is then analyzed and put into reports for our clients to understand their return on investment (ROI) on contracting athletic trainers and for our ATs to grasp the value they add to their organizations. We have been tracking this information since 2018, and with each year, we find opportunities to increase documentation standards, create greater efficiency in documentation practices, and work alongside individual sites and ATs to ensure appropriate access to the internet and devices for ease of input.
The data we receive gives us a clear picture as a company on what is going well for the ATs, where improvement can be made, and what needs to be focused on in the upcoming year to continue driving value. We provide the overall ROI to each district client, helping them translate interactions from the AT into value to their stakeholders and cost savings within their community. In the 2021-2022 school year, for every 1 dollar a client invested in Athletic Training Services, they received a return of nearly $5 in value, on average.
This year we hit a huge milestone and our client's estimated cost savings was over 10 million, $10,438,416.84 to be exact!
A few other highlights:
Total interventions = 33,057
We serviced nearly 60 sites in 2021-2022, making this an average of 550+ documented interactions at each site. Which are services that otherwise would have been seen off campus, creating a much larger inconvenience and cost to parents and team personnel.
Total cost of interventions for new evaluations = $3,903,812.16
This is the largest cost savings, capturing more than a third of the total ROI. There were 6,352 new evaluations completed across all our sites. And re-evaluations were the next highest generator at 5,524 completed for a savings of $2,339,966.40. The value of these two services alone would allow for an average return of about $3 for every $1 dollar invested. Demonstrating that the ability to have an immediate evaluation creates beneficial cost savings, even if the amount of treatment then rendered is minimal.
All treatment types combined = $3,842,352.96
Carrying the majority of the value in treatment types are Therapeutic & Functional Exercises, totaling 71% of all ROI for treatment types. Modalities (whirlpool, ultrasound, E-stim) carried the lowest value of all treatment types offering only 3% of the total value.
The story we like for this data to tell is that having athletic trainers as part of an organization's comprehensive care is a no-brainer. Not only is it essential for the safety of athletics, but it provides immense value directly to the client and the community at large. The ability to quantify the value of an AT has made an impact on how we're able to "sell" AT positions and we are excited to continue refining our process to make this decision an easy one for every client out there.
See the infographic below for a breakdown of all 2022 ROI stats.
What conclusions can we draw?
We do not believe that as the average ROI increases or decreases each year that the actual value of an AT is going up or down. Instead, we believe it is indicative of documentation practices. As we continue to see an increase in the average ROI, we believe we are getting closer and closer to the real value of an athletic trainer on-campus. This is why we continue to find increasingly efficient means of documentation for our ATs, in an effort to truly capture their day-to-day interactions and the value associated with them.
Project Overview:
It's essential for athletic training services to define their value, but value is an ambiguous term that needs to be analyzed to fit within the right context. Value is quickly becoming an overused word within athletic training and there are numerous forms of value that will be helpful within the athletic training profession. The following project focuses on the metrics of services that were provided by ATvantage and contracted athletic trainers. The function and purpose of this project was to review injury notes and treatment interventions from forty-four (44) clients of ATvantage; project goals included:
Cost savings metrics generated by each athletic trainer through the analysis of applied interventions
This included identified cost savings data based off treatment procedures compared with the national average CPT coding data
Generated net cost savings along with Return of Investment (ROI)
Estimated cost savings and return on investment procedures are calculated and assessed by this process:
Data mining of the Treatment Tracker and injury note spreadsheet. AT interventions are provided within the final calculations and include CPT code cost comparisons of the following procedures.
i. New evaluation – 97161
ii.Re-evaluation – 97164
iii.Concussion evaluation – 96132
iv.Whirlpool – 97022
v.Ultrasound – 97035
vi.Contrast Bath Treatment – 97034
vii.E-stim – 97032
viii.Therapeutic Exercises – 97110
ix.Functional Exercises – 97530
x.Manual Therapies – 97140
Utilization of CPT Coding Costs – National Average
Overview - Since there are multiple jurisdictions, it was deemed appropriate to utilize the national average CPT coding costs; the goal is to provide consistency.
Direct Cost Breakdown – The cost of interventions is taken into consideration when the AT conducts services. Direct costs are considered costs that have a dollar value in relation to medical services rendered.[i] Most direct costs are attributed to money the parent or guardian would pay if there was no access to an athletic trainer.
Indirect Cost Breakdown – The formula included an indirect cost variable. This indirect cost has been linked to being 5 times the direct cost which was included within the formula.[ii] These costs are associated with overhead which results in a musculoskeletal injury. For a secondary school, these costs may be related to:
Lost learning time
Parent/guardian time away from work to transport their child to appointments
Additional costs and time loss for paperwork focused on legal or administrative filings
Liability.
Citations:
[i]Millikin B. Worth to value: How do you define? - nata. Worth to Value: How do you define?https://www.nata.org/sites/default/files/revenue-reimbursement-define-worth-vs-value.pdf. Accessed September 1, 2022.
[ii] Manuele, Fred A.. "Accident Costs: Rethinking Ratios of Indirect to Direct Costs." Prof. Safety 56 (2011): 39–47.
