Through the tests they order, the drugs they prescribe, and the range of services they provide, physicians generate bills to third-party payors, including commercial insurance companies and government-subsidized health insurance providers such as Medicare.
Allied Healthcare Professional Revenue and ROI Report Analysis Showing Revenue Generated by Contingent Allied Radiology and Rehabilitation Professionals, Including Potential ROI
Allied Healthcare Professional Revenue and ROI Report
ABOUT AMN HEALTHCARE AMN Healthcare is the leader and innovator in total talent solutions for healthcare organizations across the United States. People are the heart of healthcare, and at the core of our mission is a commitment to ensure all may thrive. Through a steadfast partnership approach, we solve the most pressing workforce challenges to enable better clinical outcomes and access to care. We provide a comprehensive network of quality healthcare professionals and deliver a fully integrated and customizable suite of workforce technologies. For over 40 years we have served the healthcare community with workforce planning, recruitment and placement technologies and services, creating a breadth of job opportunities in all specialties and settings, physical and virtual, across the country. Our extensive network of top-tier healthcare professionals includes nurses, physicians, allied health professionals, interpreters, and leaders. We support various employment options, enhancing flexibility for organizations and guiding healthcare professionals throughout their careers. Our values are core to who we are. We prioritize inclusivity, valuing a multitude of backgrounds and viewpoints, and strive to build a diverse, skilled team that mirrors the communities we serve. At AMN Healthcare, we are empowering the future of care. Through our Center for Workforce Research, AMN Healthcare publishes multiple surveys and other research reports each year that provide original data and analysis on a variety of healthcare workforce- related topics, including healthcare professional compensation, supply and demand trends, practice metrics, provider morale and others.
ALLIED PROFESSIONAL STAFFING AND REVENUE CYCLE SOLUTIONS This report was prepared with the assistance of AMN Healthcare’s Allied Solutions division , which specializes in staffing a wide range of allied healthcare professionals at multiple types of healthcare facilities nationwide. Assistance also was provided by our Revenue Cycle Solutions division , which specializes in a wide range of revenue cycle support services, including analysis, training and support of revenue cycle management, clinical documentation review, coding quality audits, DRG valuation audits and others.
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Allied Healthcare Professional Revenue and ROI Report
INTRODUCTION: A KEY SOURCE OF REVENUE Through the tests they order, the drugs they prescribe, and the range of services they provide, physicians generate bills to third-party payors, including commercial insurance companies and government-subsidized health insurance providers such as Medicare. AMN Healthcare quantified annual billing submitted by physicians to commercial payors in our 2023 Physician Billing Report . This report indicates that physicians bill an annual gross average of $3.8 million a year to commercial payors alone, not including billing submitted to Medicare and other government payors. These billings generate significant net revenue streams to both physicians in private practices and to the hospitals, medical groups and other entities that commonly employ physicians. However, it is not just physicians who generate direct and indirect revenue for their practices or employers. Oher types of health professionals also generate direct and indirect revenue through the services they provide. In this report, AMN Healthcare tracks how certain types of allied healthcare professionals, including radiology professionals, physical therapists (PTs) occupational therapists (OTs) and speech language pathologists (SLPs) act as both direct and indirect revenue generators. It compares the cost of staffing these providers on a contingent basis to the net revenue generated from their activities, thereby demonstrating the potential return on investment (ROI) that can be realized from contingent allied professionals. Data included in the survey may prove useful to healthcare administrators tracking labor investment and ROI metrics, and to healthcare professionals, academics, journalists and others who follow healthcare workforce trends. METHODOLOGY To derive the numbers referenced in the report, AMN Healthcare’s Revenue Cycle Solutions division used internal data to track the daily cost of staffing allied radiology professionals and rehabilitation therapy professionals (e.g., PTs, OTs and SLPs) on a contingent basis. It contrasted this number with the gross average daily revenue generated by these providers based on the average number of cases they conduct and the average billing submitted for these cases. The payment rate per case is based on averages derived from real world billing submitted for radiology and therapy services nationwide. Investment gains (payments less investment costs) are computed over various time periods for which contingent allied radiology and rehabilitation professionals may be employed, including standard 13-week assignments, 6-month assignments and one-year assignments. These numbers indicate the net potential ROI of utilizing contingent allied professionals, as well as the opportunity cost of not having these professionals in place over given periods of time. Hospitals, medical groups and other employers of allied radiology and rehabilitation professionals can use a similar method for calculating potential ROI of their permanent staff by inserting permanent staff payments/ costs into the formula.
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Allied Healthcare Professional Revenue and ROI Report
KEY FINDINGS
Following are several key findings of AMN Healthcare’s 2024 Allied Healthcare Professional Revenue and ROI Report
Certain types of allied healthcare professionals, including radiology and rehabilitation professionals, are significant sources of direct net revenue for their employers. They also can be sources of an even greater amount of indirect revenue. Cath lab technologists generate the greatest amount net ROI among allied radiology professionals tracked in the survey. After the cost of utilizing them is deducted, they generate average revenues of $2,848,500 a year. Net average ROI after a 13-week assignment is $117,572. These and other numbers in the survey suggest the opportunity cost of not having allied radiology and rehabilitation professionals in place. In the case of cath lab technologists, the opportunity cost of not having a professional in place pro rates to $237,375 per month, or $54,778 per week. Multi-modality vascular sonographers rank second among allied radiology professionals, generating an average net ROI of $1,371,750 per year, less contingent labor costs. Net average ROI after a 13-week assignment is $356,655. Nuclear medicine technologists rank third, generating an average net ROI of $1,275,090 per year, less contingent labor. Net average ROI after a 13-week assignment is $331,523. Radiation therapists rank fourth, generating an average net ROI of $1,000,275 per year, less contingent labor. Net average ROI after a 13-week assignment is $260,071. General radiology technologists rank fifth, generating an average net ROI of $626,250 per year, less contingent labor. Net average ROI after a 13-week assignment is $162,825 Indirect revenue generated by allied radiology professionals may average in the millions of dollars per year. Per AMN Healthcare’s 2023 Physician Billing Report , radiologists submit an average billing of $2,031,501 to commercial payors annually ($4.1 million at the 75th percentile). Much of this billing could not be generated without the images taken by allied radiology professionals. Similarly, few surgical procedures can be conducted without images taken by allied radiology professionals. Per AMN Healthcare’s 2023 Physician Billing Report , orthopedic surgeons submit an average of $9,809,514 to commercial payors annually ($21,144,524 at the 75th percentile). Revenue derived from many types of surgeons and specialists also can be forfeited or delayed when allied radiology professionals are not available to take images and provide other services. Rehabilitation professionals also generate direct revenue. PTs, OTs, and SLPs generate an average ROI of $225,000 per year, less contingent labor costs. Net average ROI after a 13-week assignment is $58,500. Indirect revenue generated by PTs and OTs is difficult to calculate, but without an adequate number of therapists procedures requiring therapy may be delayed or lost to competitors who do provide access to therapy services.
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Allied Healthcare Professional Revenue and ROI Report
MARKET CONTEXT: THE WIDESPREAD USE AND GROWING SHORTAGE OF ALLIED HEALTHCARE PROFESSIONALS AMN Healthcare’s 2024 Allied Healthcare Professional Revenue and ROI Report was completed at a time when allied healthcare professionals are playing a larger role in healthcare delivery, while the number and the number of these professionals is in short supply. The Association of Schools of Allied Health Professions (ASAHP) defines allied health broadly as “those health professions that are distinct from medicine and nursing.”
There now are over 80 job categories in the allied health professions that include but are not limited to:
√ Physical Therapists √ Electrophysiology Technologists √ EKG Technicians √ Electroencephalography (EEG) Technologists √ Polysomnographic Technologists √ Computed Tomography Technologists √ Interventional Radiology Technologists √ Magnetic Resonance Technologists
√ Special Procedures Technologists √ Vascular Sonographers √ Clinical Laboratory Scientists √ Cytologists √ Histotechnicians √ Histotechnologists √ Medical Laboratory Technicians √ Medical Technologists √ Phlebotomists √ Dialysis Technologists √ Nutritionists √ Dieticians √ Occupational Therapists √ Speech Language Pathologists √ Respiratory Therapists
√ Laboratory Technologists √ Endoscopy Technician √ Medical Dosimetrists
√ Medical Physicists √ Radiation Therapists
√ Cardiac Monitor Technicians √ Cardiovascular Interventional Technologists √ Cath Lab Technologists √ Echo Technologists √ Pharmacy technicians √ Dental Hygienists √ Emergency Medical Technologists/Paramedics √ Exercise Physiologists √ Medical Assistants
√ Mammographers √ Nuclear Medicine Technologists √ Radiologic Technologists √ Sonographers
Source: Bureau of Labor Statistics Occupational Outlook Handbook
Together with a range of technical and support staff, allied healthcare professionals may deliver direct patient care, rehabilitation, treatment, diagnostics, and health improvement interventions to restore and maintain optimal physical, sensory, psychological, cognitive, and social functions.
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Allied Healthcare Professional Revenue and ROI Report
According to the Census Bureau’s American Community Survey, approximately 22 million people nationwide are employed by the healthcare and social services sector. Healthcare/social services now employs more people than any other sector of the economy – approximately 14% of all American workers. Of the 22 million workers in this sector, approximately 60% can be classified as allied healthcare professionals, according to the ASAHP. Allied healthcare professionals are on the front lines of healthcare and provide services to millions of Americans every day. SUPPLY NOT MEETING DEMAND In AMN Healthcare’s 2022 Survey of Allied Health Care Professional New Graduate Hiring Patterns , 85% of respondents indicated that their healthcare facilities are experiencing allied healthcare professional labor shortages either “a great deal”, “a lot” or “a moderate amount.” Only 15% said they are experiencing allied healthcare professional labor shortages either “a little” or “not at all.” Close to three quarters of respondents (71%) indicated that allied healthcare professional openings are taking longer to fill, while close to half (46%) said that burnout among allied healthcare professionals presents a staffing challenge.
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Allied Healthcare Professional Revenue and ROI Report
MORE ALLIED RADIOLOGY PROFESSIONALS NEEDED
Among allied professionals, radiology professionals in various modalities are in particularly high demand, with many positions going unfilled. The American Society of Radiologic Technologists (ASRT) Radiologic Science Staffing and Workplace Survey showed a 2023 imaging technology vacancy rate of 18.1%, as reported by radiology department heads nationwide. This is up from 6.2% in 2021 and is an all-time high since the survey was first conducted in 2001. The survey found the following increases in vacancy rates in various imaging modalities compared with 2021:
2021
2023
7.1%
18.6%
8.7%
17.7%
6.9%
16.7%
8.7%
16.2%
4.2%
14.5%
4.3%
13.6%
3.8%
6.9%
Cardiovascular interventional technology
Computed tomography
Sonography
Magnetic resonance imaging
Nuclear medicine
Mammography
Bone densitometry
The survey also noted that survey respondents work in:
13.7%
9.6%
53%
imaging centers
physician's offices
hospitals
Demand for imaging technologists is exceeding supply for a number of reasons, a primary one being population aging. Older people generate a proportionately higher percent of imaging tests than younger people, creating more demand for diagnostic images than there are technologists to take them.
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Allied Healthcare Professional Revenue and ROI Report
REHABILITATION PROFESSIONALS ALSO ARE IN SHORT SUPPLY Similarly, the American Physical Therapy Association’s (APTA) Hiring Challenges in Outpatient Physical Therapy report tracked 2022 personnel vacancy rates at outpatient physical therapy practices nationwide. The total vacancy rate reported by these practices was 16%. Vacancy rates were highest for PTs at 17%, followed by 14% for support personnel and 13% for physical therapy assistants (PTAs). The demand for OTs also is rising, with job growth expected to increase 17% from 2020 through 2030, according to the US Bureau of Labor Statistics. Vacancy rates for OTs vary and may be somewhat lower than vacancy rates for PTs or comparable depending on type and location of practice. According to the U.S. Bureau of Labor Statistics (BLS), approximately 150,000 SLPs are employed nationwide. Of these, 60,920 are employed by elementary and secondary schools. The demand for SLPs is high, with the BLS projecting that SLP employment will grow 21% from 2021 to 2031. On average, the BLS projects openings for SLPs at 14,000 per year for the next decade, with many of these openings caused by the need to replace workers who transfer to different occupations or who retire. THE RISE OF CONTINGENT ALLIED HEALTHCARE PROFESSIONAL STAFFING The use of contingent or “travel” nurses is common throughout the healthcare system, as is the use of physicians who travel to temporary assignments (known as “locum tenens”). For decades, travel nurses and locum tenens physicians have been utilized to fill gaps in clinical staffs that occur due to worker shortages, turnover or temporary absences. The use of contingent or “travel” allied healthcare professionals also now is widespread. Allied professionals are part of an increasingly mobile healthcare workforce that allows employers to fill workforce gaps and utilize more flexible staffing options. AMN Healthcare’s 2021 Survey of Temporary Allied Healthcare Professional Staffing Trends found that 96% of hospitals and other healthcare facilities had used travel allied healthcare professionals sometime in the last 12 months to supplement their staffs. Fifty-six percent of allied professionals used were either radiology professionals, PTs, OTs, or SLPs, who are the focus of this report.
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Allied Healthcare Professional Revenue and ROI Report
INVESTMENT AND DAILY GROSS RETURN There is an investment attached to using travel allied healthcare professionals that is accrued to healthcare facilities based on a daily rate for the services these professionals provide. The rate varies by allied healthcare professional type. The chart below lists travel allied radiology professionals in various types of modalities, PTs, OTs, and SLPs, the daily investment for their services based on bill rates derived from AMN Healthcare data, and the average gross daily charges they generate based on a national data sample of billing submitted for these services. The chart also shows the percentage of gross revenues represented by the investment and the percent return on investment less the investment cost.
ROI - % Gained after Labor Investment
Travel Allied Professional Specialty
Total Daily Labor Cost Est. Daily Gross Revenue *
Daily Investment %
67.5%
CT (Computed Tomography)
$870.00
$2,678.80
32.5%
72.0%
Echo Cardiographer
$825.00
$2,950.24
28.0%
27.3%
Echo Cardiographer – Pediatric Specialty
$750.00
$1,032.00
72.7%
77.3%
General Radiology Technologist
$735.00
$3,240.00
22.7%
59.3%
Mammography Technologist
$757.50
$1,863.45
40.7%
60.0%
Occupational Therapist
$600.00
$1,500.00
40.0%
60.0%
Physical Therapist
$600.00
$1,500.00
40.0%
6.8%
Sonographer – General (OB, AB, BR, Small Parts)
$825.00
$885.33
93.2%
53.6%
Sonographer - High Risk OB
$862.50
$1,860.00
46.4%
86.9%
Sonographer - Multi-Modality/Vascular
$825.00
$6,312.00
13.1%
60.0%
Speech Language Pathologist
$600.00
$1,500.00
40.0%
64.8%
Vascular Interventional Technologist
$937.50
$2,660.00
35.2%
81.0%
Radiation Therapist
$937.50
$4,938.60
19.0%
92.1%
Cath Lab Technologist
$975.00
$12,369.00
7.9%
70.2%
MRI Technologist
$802.50
$2,692.08
29.8%
86.8%
Nuclear Medicine Technologist
$772.50
$5,872.86
13.2%
*Estimated Avg No. Cases x Estimated Avg Payment
As these numbers indicate, average daily gross charges submitted by allied radiology professionals, PTs, OTs and SLPs vary from a high of $12,369 for cath lab technologists to a low of $885.50 for general sonographers. Percent of investment relative to average gross charges also varies. While cath lab technologists generate the highest average daily charges, the investment made in their services is comparatively low, at just 7.9% of gross charges. Consequently, return on investment for cath lab technologists is 92.1% of gross daily charges, the highest return tracked in the report.
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Allied Healthcare Professional Revenue and ROI Report
By contrast, general sonographers generate a relatively low gross daily charge of $885.33, with a relatively low return on investment of 6.8%. In each specialty listed above, average daily gross revenues generated per allied professional exceed the investment made, indicating that at minimum, travel allied radiology professionals, OTs, PTs and SLPs cover the investment made in their services and in most cases generate surplus direct revenue. As referenced above, these numbers do not include indirect revenue generated by these professionals, which may include payments for services provided by radiologists who read the images taken by allied radiology professionals or payments to surgeons and other specialists who require images to perform surgical procedures and diagnostic work. This indirect revenue may often greatly exceed the direct revenue generated by allied professionals, as is indicated in AMN Healthcare’s Physician Billing Report . AVERAGE DAILY SCANS/CASES AND PAYOR PAYMENT AMOUNTS The chart below shows the average number of daily scans taken by travel allied radiology professionals, as well as the average cases seen by travel PTs, OTs and SLPs based on AMN Healthcare internal data. The chart also shows the estimated average amount reimbursed by payors per each scan or case seen based on a national data sample of real-world billing. These amounts may vary widely by geographic region.
Travel Allied Professional Specialty
Average Case/Scan per Day
Reimbursement Amount Per Scan/Case
CT (Computed Tomography)
10
$267.88 $368.78 $129.00 $108.00 $124.23 $150.00 $150.00 $98.37 $310.00 $789.00 $250.00 $665.00 $493.86 $4,123.00 $299.12 $652.54
Echo Cardiographer
8 8
Echo Cardiographer – Pediatric Specialty
General Radiology Technologist Mammography Technologist
30 15 10
Occupational Therapist
Physical Therapist
10
Sonographer – General (OB, AB, BR, Small Parts)
9 6 8 6 4
Sonographer - High Risk OB
Sonographer - Multi-Modality/Vascular
Speech Language Pathologist
Vascular Interventional Technologist
Radiation Therapist Cath Lab Technologist
10
3 9 9
MRI Technologist
Nuclear Medicine Technologist
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Allied Healthcare Professional Revenue and ROI Report
As these numbers indicate, the volume of average daily scans taken by allied radiology professionals may vary, from a high of 30 for general radiology technologists to a low of three for cath lab technologists. However, though cath lab technologists take the fewest scans, average payment per scan is by far the highest at $4,123. It again should be stressed that payment amounts can vary widely by region and that the numbers above reflect national averages. NET INVESTMENT GAIN BY TIME PERIOD The chart below shows the net investment gain that may be realized from the use of contingent radiology professionals, PTs, OTs and SLPs over three distinct time periods. These include a 13-week period, which is the standard length of a contingent allied healthcare professional contract. Given the shortage of allied professionals, assignments can extend to six months or even one year, and these periods also are shown in the chart.
13 Week Net Investment Gain (Payment less investment Cost)
6-Month Net Investment Gain (Payment less investment Cost)
Annual Net Gain (Payment less investment Cost)
Travel Allied Professional Specialty
CT (Computed Tomography)
$117,572.00
$226,100.00
$452,200.00
Echo Cardiographer
$138,140.60
$265,655.00
$531,310.00
Echo Cardiographer – Pediatric Specialty
$18,330.00
$35,250.00
$70,500.00
General Radiology Technologist
$162,825.00
$313,125.00
$626,250.00
Mammography Technologist
$71,886.75
$138,243.75
$276,487.50
Occupational Therapist
$58,500.00
$112,500.00
$225,000.00
Physical Therapist
$58,500.00
$112,500.00
$225,000.00
Sonographer – General (OB, AB, BR, Small Parts)
$3,921.45
$7,541.25
$15,082.50
Sonographer - High Risk OB
$64,837.50
$124,687.50
$249,375.00
Sonographer - Multi-Modality/Vascular
$356,655.00
$685,875.00
$1,371,750.00
Speech Language Pathologist
$58,500.00
$112,500.00
$225,000.00
Vascular Interventional Technologist
$111,962.50
$215,312.50
$430,625.00
Radiation Therapist
$260,071.50
$500,137.50
$1,000,275.00
Cath Lab Technologist
$740,610.00
$1,424,250.00
$2,848,500.00
MRI Technologist
$122,822.70
$236,197.50
$472,395.00
Nuclear Medicine Technologist
$331,523.40
$637,545.00
$1,275,090.00
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Allied Healthcare Professional Revenue and ROI Report
As these numbers indicate, the net investment gain after contingent costs over 13 weeks approaches three quarters of a million dollars for cath lab technologists on the high end and approximately $4,000 for general sonographers on the low end. In each case, however, a net gain is achieved while services are being maintained, which, in turn, may generate indirect revenue from radiologists, surgeons and other types of physicians. Over a six-month period, net gain exceeds $100,000 in all but two specialties (echo cardiographer and general sonographer) and exceeds $200,000 in 9 of the 16 specialties listed. Over a one-year period, net gain exceeds $1 million in four of the 16 specialties and approaches $3 million for cath lab technologists. OPPORTUNITY COSTS The analysis above demonstrates the revenue that may be gained by the use of travel allied radiology and rehabilitation professionals. By extension, it also implies the revenue that may be lost by not having travel or permanent allied professionals in place. The opportunity cost can be as high as $2.8 million a year for a cath lab technologist to a low of $15,000 per year for a general sonographer.
PERMANENT VS. CONTINGENT ALLIED PROFESSIONAL ROI
Healthcare professionals who work on temporary assignments, whether nurses, physicians or allied healthcare professionals, are meant to be a supplement to permanent staff, not a substitute. Traditionally, they have been used to fill in for permanent staff who are temporarily absent due to vacation, illness, training or other reasons. They often can be used strategically to staff up or down as needed based on varying levels of patient demand. As this report indicates, healthcare facilities can achieve a positive return on investment when using certain contingent allied healthcare professionals. The same can be said of permanent allied healthcare professionals, who also generate direct and indirect revenue. Healthcare facilities that employ permanent allied radiology professionals, PTs, OTs and SLPs can calculate the ROI of their investment in these professionals by inserting their daily employment costs into the formula used above. Where the total cost of employing permanent professionals is comparable to using contingent professionals, ROI also will be comparable. Where it is less, ROI will be greater and where it is more, ROI will be less.
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Allied Healthcare Professional Revenue and ROI Report
CONCLUSION Labor costs often are the first line item in the budgets of hospitals, medical groups and other healthcare facilities. However, certain types of healthcare professionals offset the cost of employing them through the direct and indirect revenue they generate, whether working on a contingent basis or on a permanent basis. AMN Healthcare’s 2024 Allied Healthcare Professionals Revenue and ROI Report indicates that allied radiology professionals, PTs, OTs and SLPs are included in this group. The report shows that these allied healthcare professionals generate a return on investment of as much as 92%. They often generate over $100,000 in net revenue when working on 13-week assignments and commonly generate over $1 million in direct revenue when working on one-year assignments. The same holds true for those in permanent staff positions, who may generate a comparable, greater, or lesser ROI depending on the daily cost of employing them.
Healthcare facilities therefore should consider the revenue generating potential of allied and other healthcare professionals when determining their overall workforce investment. For more information about this report and other AMN Healthcare thought leadership resources, visit AMNHealthcare.com
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