CAI’s LARC Modeling Tool

Understanding the Net Cost of Providing Long Acting Reversible Contraception Services (LARC)

CAI’s LARC Modeling Tool resource is intended to support healthcare service providers to examine assumptions about the affordability of LARC methods.

To begin using the tool, complete the fields below.

Click here to access instructions

Payer Mix Costs and Reimbursements Reimbursement Calculations
Type Proportion of Clients Number of
Clients
1Device Cost
(Device: )
2Device Reimbursement
(Device: )
3Visit Reimbursement 4Insertion Reimbursement Net**
Medicaid Managed Care
 
Medicaid Fee-for-Service*
 
Private Insurance
 
Self-Pay*
 
Uninsured/No Pay Clients
 
Other
 
Spot Check:
 
Total

We've crunched the numbers!

Additional Notes

Question: What about the cost of inserting the device? That is not included.

Answer: This is a very good point. This analysis does not consider the overhead costs associated with inserting a LARC device. You may also wish to incorporate the cost of inserting the LARC device into your calculations. This entails looking at your agency’s most recent cost analysis, determining the costs associated with the insertion and the identified visit code, and including the sum of these two costs and the cost of your LARC device in the “Device Cost” column.

 

Question: What about the significant outlay of funds needed to purchase LARC devices in advance?

Answer: This also is a valid point. Even if you break even providing LARC, your agency still will have to expend significant funds to purchase devices well in advance of receiving reimbursement. You can address this concern by implementing best practices for properly managing your stock of LARC, timely claims submission and reconciliation, and investing grant dollars (if available) to purchase a “base” supply of LARCs, which will be replenished as reimbursements for inserted devices are secured.

 

A final note…

In providing LARC services, you provide a valuable service in your community, and the rates you are reimbursed should reflect this value. Even if you will break even or make a profit from providing LARC services, it is still important to support it in receiving fair reimbursement for the services you are providing. We also encourage you to do a cost analysis to determine the true cost of providing services.