Model Design by Kelly Emrick, DHSc, PhD, MBA, (ARRT)R
Two Models Below
Healthcare Fiscal Performance
The Highest-Leverage Fix in Healthcare
Redesign incentives around timely access, prevention, and measurable outcomes — and model the dollars. Adjust any assumption; every cost pool, projection, and return metric recalculates live.
The investment case at a glance
Front-door friction quietly funds avoidable ED use, delayed diagnoses, clinician turnover, avoidable admissions, leakage, and rework. Here is what redirecting a slice of that waste returns.
Addressable friction / yr
Total recoverable waste
Steady-state benefit / yr
Savings + value-based upside
Net benefit / yr
After recurring opex
5-year NPV
Discounted at WACC
Benefit-cost ratio
PV benefit per $1 cost
Payback period
From program launch
Assumptions & drivers
Replace these defaults with your organization’s actuals. Everything downstream updates instantly.
Downstream failure costs
The six friction-driven cost pools that compound when the front door breaks.
| Cost pool | Annual cost | % of total |
|---|---|---|
| Emergency department overuse | – | – |
| Avoidable admissions | – | – |
| Delayed diagnoses | – | – |
| Clinician burnout & turnover | – | – |
| Patient frustration / leakage | – | – |
| Administrative friction & rework | – | – |
| Total addressable friction | – | 100% |
Where the waste sits
The highest-leverage fix
Not another isolated program — a payment & operating model with six levers. Edit each lever’s one-time and recurring cost.
Total one-time investment
Upfront build
Total annual recurring
Operating cost
Impact model
Set the achievable reduction on each cost pool. Savings are steady-state (full ramp).
| Subtotal — cost savings | – |
| Value-based incentive (new revenue) | – |
| Total annual benefit | – |
| Blended reduction across pools | – |
Baseline cost vs. realizable savings
5-year financial projection
Year 0 is the build year (you staff up before savings arrive). Savings ramp via the realization curve.
| $ (000s) | Year 0 | Year 1 | Year 2 | Year 3 | Year 4 | Year 5 |
|---|---|---|---|---|---|---|
| Total benefits | – | – | – | – | – | – |
| Total costs | – | – | – | – | – | – |
| Net cash flow | – | – | – | – | – | – |
| Cumulative | – | – | – | – | – | – |
Benefits, costs & cumulative cash flow
ROI, NPV & payback
The headline financial case, discounted at your cost of capital.
Net present value
Value-creating if > 0
Benefit-cost ratio
PV benefit per $1 PV cost
Internal rate of return
High for opex-funded programs
Payback period
Years from launch
5-yr net cash flow
Undiscounted
5-yr total benefits
Undiscounted
5-yr total costs
Incl. one-time
5-yr return on investment
Net / total cost
Scenario analysis
Stress-test the same program. Multipliers scale savings, incentive capture, and cost.
Conservative
Base
Aggressive
Multipliers
Cons incentive
Cons cost
Aggr savings
Aggr incentive
Aggr cost
5-year NPV by scenario
Measurable outcomes — KPI scorecard
Proof the system is performing differently. Access targets are illustrative; utilization targets are computed live from your reductions.
| KPI | Baseline | Target | Improvement |
|---|---|---|---|
| Third-next-available (days) | 24 | 7 | -71% |
| New-patient call abandonment | 18% | 6% | -67% |
| Online self-scheduling share | 10% | 60% | +500% |
| Referral leakage rate | 25% | 12% | -52% |
| No-show rate | 14% | 8% | -43% |
| KPI | Baseline | Target | Improvement |
|---|---|---|---|
| Avoidable ED visits / yr | – | – | – |
| Avoidable admissions / yr | – | – | – |
| Provider turnover rate | – | – | – |
| Steady-state net benefit | – | – | |
Avoidable utilization: baseline vs target
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