Economic Viability Calculator
Designed by Kelly Emrick
EXECUTIVE DECISION MODEL • OUTPATIENT MRI
Economic Viability, Capacity & Break-Even Calculator
Translate patient demand, multi-procedure encounters, payer collections, cost absorption, scanner time, and debt service into one defensible operating scenario.
MODEL SIGNAL
Calculating scenario
Illustrative assumptions • saved on this device
Review input totals. The calculation normalizes payer and procedure mix, but final distributions should equal 100%.
FIXED-COST ABSORPTION
Average economics by monthly procedure volume
Monthly procedures on the horizontal axis; dollars per completed procedure on the vertical axis.
Net collectionAverage total costFixed cost allocation
REVENUE DIVERSIFICATION
Payer mix
Share of completed procedures, normalized to 100%.
First procedure collectionAdditional procedure collectionBlended realized collection
OPERATING POSITION
Monthly margin bridge
Revenue conversion through operating and financing obligations.
PATIENT-TO-PROCEDURE ECONOMICS
Volume, payer mix & protocol architecture
Separate completed patient encounters from billable MRI procedures, then model revenue and scanner time by mix.
Procedures per patient additional procedures this month
PAYER ASSUMPTIONS
Expected net collections
Enter realized collections, not gross charges. Additional-procedure factors are payer-specific.
| Payer | Mix | Net collection | Additional procedure |
|---|---|---|---|
| Commercial | % | $ | % |
| Medicare | % | $ | % |
| Cash pay | % | $ | % |
| Workers comp / other | % | $ | % |
Multiple-procedure logic: The first procedure earns the full expected net collection. Additional procedures use the payer-specific factor. Medicare defaults to 50% for technical-component services subject to MPPR indicator 4; confirm each code and payer contract.
PROTOCOL ASSUMPTIONS
Procedure mix and scanner time
Slot minutes include acquisition, positioning, and ordinary turnaround time.
| Protocol group | Mix | Slot minutes | Supplies |
|---|---|---|---|
| Routine noncontrast | % | $ | |
| With and without contrast | % | $ | |
| Limited / abbreviated | % | $ | |
| Complex / specialty | % | $ |
Weighted slot timeWeighted supplies per procedureSame-patient turnover savings
From patients to procedures
Single-procedure encountersCompleted encountersTotal procedures
Monthly conversion
1Scheduled encounters2Completed patients3First procedures4Additional procedures5Total procedures
Required operating pace
procedures per operating day
Completed patients neededScheduled patients neededTarget-DSCR procedures
COST ABSORPTION & OPERATING LEVERAGE
Fixed, variable, step, and financing costs
Keep accounting earnings, operating EBITDA, and lender cash requirements distinct.
Average total costper completed procedure at current volume
MONTHLY FIXED OPERATING COSTS
Cost base before incremental volume
Per patient, procedure, and collection
Incremental operating shift
The added cost activates once monthly procedures exceed the threshold. Use it for additional staffing, extended hours, or another discrete capacity requirement.
Debt and noncash obligations
CONSTRAINED-RESOURCE ECONOMICS
Scanner capacity and throughput
Financially attractive demand is useful only if it fits within safe, staffed, and technically achievable scanner time.
Contribution / scanner hourcurrent encounter and protocol mix
Practical capacity inputs
Practical utilization
Practical scanner hoursUsed scanner hoursUnused practical hours
Sustainable procedure volume
estimated procedures per month
Current completed proceduresHeadroom to sustainable ceilingWeighted slot time
PROTOCOL PRODUCTIVITY
Illustrative contribution by scanner hour
Uses weighted first-procedure collections and current cost assumptions. This is an operational comparison, not a payer recommendation.
UNCERTAINTY & LENDER RESILIENCE
Scenario and sensitivity laboratory
Stress volume and collection together, then evaluate operating break-even, cash generation, DSCR, and capacity.
Margin of safetyforecast volume above operating break-even
TWO-WAY SENSITIVITY
Monthly EBITDA by volume and collection realization
Scheduled encounters across columns; realized collection assumption down rows.
TWELVE-MONTH RAMP
No seasonality appliedEBITDA and cash after debt service
Illustrative linear ramp from 64% to 100% of selected monthly scheduled volume.
EBITDACash after debt service
METHODS, DEFINITIONS & GOVERNANCE
Transparent model logic
Every output is derived from editable assumptions. Literature informs the structure; local center data must determine actual values.
Snapshot dateAug. 4, 2026published model, not a live payer connection
Procedures per patient
1 + two-procedure share + (2 × three-procedure share)Monthly revenue
first procedures × first collection + additional procedures × adjusted collectionAverage total cost
(fixed + step + variable costs) ÷ completed proceduresOperating break-even
lowest volume where revenue − variable − fixed − step costs ≥ 0Scanner utilization
used scanner minutes ÷ practical staffed scanner minutesDebt service coverage
monthly EBITDA ÷ monthly principal and interest debt serviceDecision-ready outputs
Operating break-evenMinimum completed encounter mix needed for EBITDA of zero.Target-DSCR volumeMinimum completed volume needed for EBITDA to equal target DSCR multiplied by debt service.Contribution per scanner hourNet collected revenue less modeled variable costs, divided by used scanner hours.Margin of safetyForecast completed patients above break-even, divided by forecast completed patients.Practical capacityStaffed scanner minutes adjusted for equipment uptime. Sustainable capacity applies the selected ceiling.
Selected research and policy sources
- Lexa, Mehta, and Seidmann (2005)Managerial accounting, fixed cost, marginal cost, unused capacity, and cost-volume-profit analysis in radiology.
- Shankar, Hayatghaibi, and Anzai (2020)Time-driven activity-based costing in radiology.
- Hayatghaibi et al. (2023)MRI cost variation by workflow and acquisition time.
- Herold et al. (2025)Outpatient MRI facility design, turnaround time, and throughput.
- CMS status indicators (2026)Diagnostic imaging multiple-procedure payment adjustment rules.
Model governance statement
This calculator is a working decision-support laboratory. It does not replace audited financial statements, payer-contract review, coding advice, valuation, feasibility analysis, or lender underwriting. Outputs should be reconciled to de-identified encounter data, remittance records, the general ledger, staffing schedules, debt documents, and actual scanner logs before use.