Cost of TB Treatment, Evaluation and Case Management Kate Louther, RN MS Public Health Supervisor Public Health Madison & Dane County Disclosures  None TB Cost Random sampling of TB clients from 2009-2012  Only pulled client records if treatment was complete and/or if the chart was closed Costs of medical tests, procedures and appointments were collected using TB dispensary client bills; costs were averaged from four medical clinics in Dane County Medical Costs  Varied clinic to clinic Established New Office Visit Office ($) Visit ($) Avg: $210.43 Chest X-ray 2 View ($) Blood Draw ($) LFT ($) QFT ($) $400.50 $130.25 $32.50 $90 $406.17 Price Ranges for Medical Services Across Four Community Clinics Est. Office Visit ($) Range New Office Visit ($) Range Chest X- Venipu- LFT ray ncture ($) 2 VW ($) Range ($) Range Range 144-361 242-567 64-227 PHMDC* Avg: 27-41 86110 QFT ($) Range T-spot ($) Range 175.50543 NA 3.88 $210.43 $400.50 $130.25 $32.50 55 58.50 $90 $406.17 Actual PHN Cost of Case Management Cost of Nursing Case Management (# hours x PHN Wage) (MA reimbursement) Pulm. TB Average Cost= $7,293.95 Average Cost=$2,675.17 Extrapulm. TB Average Cost= $5,048.51 Average Cost=$2,795.42 TB Average Cost= $953.91 Suspect Average Cost=$541.48 Average Cost= $279.68 Average Cost=$236.11 LTBI Total Cost of TB Treatment, Evaluation & Case Management Latent TB Active TBPulm. Active TBExtrapulm. Suspect TB Total (range): Total (range): Total (range): $1244.07 $10,045.97 $7800.53 $2224.07 $10,658.47 $8413.03 Total: $1795.80 Value of TB Case Management 10% of LTBI clients will break down with active disease at some point in their life… Based on these numbers, we saved nearly $100,000 in nurse case management expenses in 2013. By treating LTBI cases, we avoid contact investigations, clients live more productive lives, clients function better in the community and the population is protected from a deadly communicable disease. Questions?