• Tyler J Miksanek, M Reza Skandari, Sandra A Ham, Wei Wei Lee, Valerie G Press, Marie T Brown, and Neda Laiteerapong.
• Pritzker School of Medicine, University of Chicago, Chicago, Illinois (T.J.M., W.W.L., V.G.P., N.L.).
• Ann. Intern. Med. 2021 Jan 1; 174 (1): 1-7.

BackgroundEconomic analyses of medical scribes have been limited to individual, specialty-specific clinics.ObjectiveTo determine the number of additional patient visits various specialties would need to recover the costs of implementing scribes in their practice at 1 year.DesignModeling study based on 2015 data from the Centers for Medicare & Medicaid Services (CMS) and National Ambulatory Medical Care Survey. Scribe costs were based on literature review and a third-party contractor model. Revenue was calculated from direct visit billing, CPT (Current Procedural Terminology) billing, and data from the National Ambulatory Medical Care Survey.Data Sources2015 data from CMS and the National Ambulatory Medical Care Survey.Target PopulationHealth care providers.Time Horizon1 year.PerspectiveOffice-based clinic.Outcome MeasuresThe number of additional patient visits a physician must have to recover the costs of a scribe program at 1 year.Results Of Base Case AnalysisAn average of 1.34 additional new patient visits per day (295 per year) were required to recover scribe costs (range, 0.89 [cardiology] to 1.80 [orthopedic surgery] new patient visits per day). For returning patients, an average of 2.15 additional visits per day (472 per year) were required (range, 1.65 [cardiology] to 2.78 [orthopedic surgery] returning visits per day). The addition of 2 new patient (or 3 returning) visits per day was profitable for all specialties.Results Of Sensitivity AnalysisResults were not sensitive to most inputs, with the exception of hourly scribe cost and inclusion of CPT revenue.LimitationUse of Medicare data and failure to account for indirect costs, downstream revenue, or changes in documentation quality.ConclusionFor all specialties, modest increases in productivity due to scribes may allow physicians to see more patients and offset scribe costs, making scribe programs revenue-neutral.Primary Funding SourceUniversity of Chicago Medicine's Center for Healthcare Delivery Science and Innovation and the Bucksbaum Institute.

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