{"edition":"new-york-city","organization":"Bergen Volunteer Medical Initiative","organizationId":"ein:20-2633437","boundaryVersion":"OMB-23-01-2023-07-21","updated":"2026-09-14","model":{"version":"nyc-bvmi-finite-clinical-v1","costScope":"Whole recipient annual gross recognized resources, including donated clinical labor/goods and netted events. Finite clinical improvement modeled across care, not full social/long-term portfolio return.","geographicAttribution":"Bergen County residency verified annually by recipient eligibility; central g=1 for modeled patients within official22-county MSA, with .98 sensitivity. No headquarters or population-share shortcut.","formula":"Qall=N*a*b*(c*u*t-h)/(1+d); QNYC=g*Qall; Price10=10*C/QNYC when positive. Central c*u*t=.0125 QALY per additional annual patient before .0005 burden; horizon at most one year.","counterfactual":"Other free/sliding-scale providers, emergency care, future insurance, volunteer availability, current grants and committed Garfield expansion continue. a removes care replacement; b removes funding replacement; they represent distinct constraints and appear once each.","attribution":"No multiplying the number of visits by full annual health, no treating disease-control benchmarks as causal response, and no claiming all new-center patients depend on this donor. Ordinary gift response is proportional and conditional.","uncertainty":"Very weak-confidence judgment-based clinical estimate, not a measured treatment effect. c,u,t,h are explicit health priors supported only qualitatively by scope and external access evidence. No inferred precise efficacy from A1C or emergency visits.","nativeOutcomes":"Distinct annual patients -> genuinely additional effective care patient-equivalents -> finite clinical utility improvement minus treatment burden.","inputs":[{"name":"C","value":4513270,"unit":"USD annual recognized gross recipient cost","basis":"observed","rationale":"Audited pre-event-netting functional expense total.","sourceIds":["audit25"]},{"name":"N","value":1026,"unit":"distinct annual patients","basis":"observed","rationale":"2025 report distinct annual patients, not visits.","sourceIds":["impact25"]},{"name":"a","value":0.5,"unit":"fraction","basis":"judgment","rationale":"Explicit modeling judgment; no source empirically estimates this factor.","sourceIds":["services","oregon"]},{"name":"b","value":0.5,"unit":"fraction","basis":"judgment","rationale":"Explicit modeling judgment; no source empirically estimates this factor.","sourceIds":["services","oregon"]},{"name":"c","value":0.25,"unit":"fraction","basis":"judgment","rationale":"Explicit modeling judgment; no source empirically estimates this factor.","sourceIds":["services","oregon"]},{"name":"u","value":0.1,"unit":"health utility difference","basis":"judgment","rationale":"Explicit modeling judgment; no source empirically estimates this factor.","sourceIds":["services","oregon"]},{"name":"t","value":0.5,"unit":"years of improvement","basis":"judgment","rationale":"Explicit modeling judgment; no source empirically estimates this factor.","sourceIds":["services","oregon"]},{"name":"h","value":0.0005,"unit":"QALYs lost per attributable patient","basis":"judgment","rationale":"Explicit modeling judgment; no source empirically estimates this factor.","sourceIds":["services","oregon"]},{"name":"g","value":1,"unit":"fraction","basis":"judgment","rationale":"Eligibility requires and annually verifies Bergen County residence; applying it to health assumes continued residency.","sourceIds":["services"]},{"name":"d","value":0.03,"unit":"annual discount rate","basis":"judgment","rationale":"Explicit modeling judgment; no source empirically estimates this factor.","sourceIds":["services","oregon"]}],"scenarios":[{"id":"central","label":"Conditional annual clinical portfolio","costUSD":4513270,"allPopulationQalys":2.9883495145631067,"editionQalys":2.9883495145631067,"assumptions":"{\"C\":4513270,\"N\":1026,\"a\":0.5,\"b\":0.5,\"c\":0.25,\"u\":0.1,\"t\":0.5,\"h\":0.0005,\"g\":1,\"d\":0.03}","pricePer10Qalys":15102885.315139702},{"id":"low","label":"Small health response and strong substitution","costUSD":4513270,"allPopulationQalys":0.018677184466019424,"editionQalys":0.018303640776699034,"assumptions":"{\"C\":4513270,\"N\":1026,\"a\":0.25,\"b\":0.1,\"c\":0.1,\"u\":0.05,\"t\":0.25,\"h\":0.0005,\"g\":0.98,\"d\":0.03}","pricePer10Qalys":2465777194.3085217},{"id":"high","label":"Broad favorable clinical response","costUSD":4513270,"allPopulationQalys":44.22757281553398,"editionQalys":44.22757281553398,"assumptions":"{\"C\":4513270,\"N\":1026,\"a\":0.8,\"b\":0.75,\"c\":0.5,\"u\":0.15,\"t\":1,\"h\":0.001,\"g\":1,\"d\":0.03}","pricePer10Qalys":1020465.2239959257},{"id":"zero","label":"Complete financing replacement","costUSD":4513270,"allPopulationQalys":0,"editionQalys":0,"assumptions":"{\"C\":4513270,\"N\":1026,\"a\":0.5,\"b\":0,\"c\":0.25,\"u\":0.1,\"t\":0.5,\"h\":0.0005,\"g\":1,\"d\":0.03}","pricePer10Qalys":null},{"id":"adverse","label":"No improvement with treatment or screening burden","costUSD":4513270,"allPopulationQalys":-0.24902912621359224,"editionQalys":-0.24902912621359224,"assumptions":"{\"C\":4513270,\"N\":1026,\"a\":0.5,\"b\":0.5,\"c\":0,\"u\":0.1,\"t\":0.5,\"h\":0.001,\"g\":1,\"d\":0.03}","pricePer10Qalys":null},{"id":"partner-cost","label":"Illustrative induced partner care","costUSD":4769770,"allPopulationQalys":2.9883495145631067,"editionQalys":2.9883495145631067,"assumptions":"{\"C\":4769770,\"N\":1026,\"a\":0.5,\"b\":0.5,\"c\":0.25,\"u\":0.1,\"t\":0.5,\"h\":0.0005,\"g\":1,\"d\":0.03}","pricePer10Qalys":15961218.648473036},{"id":"volunteer-cost","label":"Higher recognized volunteer opportunity value","costUSD":4857495.5,"allPopulationQalys":2.9883495145631067,"editionQalys":2.9883495145631067,"assumptions":"{\"C\":4857495.5,\"N\":1026,\"a\":0.5,\"b\":0.5,\"c\":0.25,\"u\":0.1,\"t\":0.5,\"h\":0.0005,\"g\":1,\"d\":0.03}","pricePer10Qalys":16254777.014294997}],"sensitivity":["The low and high scenarios jointly vary additional care, gift response, clinical improvement and duration; they are not statistical bounds.","Benefit stops within one year; no lifetime prevention award is inferred from disease-control percentages.","Partner-cost and higher volunteer-value stresses retain the same health numerator."],"missingInputs":["Condition-specific causal health outcomes against alternative care.","Current marginal funding response and capacity after committed Garfield expansion.","Unrecognized partner resources, long-term prevention and broader net social effects."],"nativeCosts":"Full annual recognized expense per observed annual patient is $4,398.9. After the separate care-additionality and gift-response factors, cost per 256.5 modeled attributable patient equivalents is $17,595.59. Neither ratio treats each repeat visit as a new person."},"sources":[{"id":"audit25","title":"2025 and 2024 audited financial statements","publisher":"Bergen Volunteer Medical Initiative","url":"https://www.bvmi.org/wp-content/uploads/2026/06/BVMI-2025-Audited-Financial-Statements-2025-24.pdf","published":null,"retrieved":"2026-09-14"},{"id":"audit24","title":"2024 and 2023 audited financial statements","publisher":"Bergen Volunteer Medical Initiative","url":"https://www.bvmi.org/wp-content/uploads/2025/05/BVMI-2024-Audited-Financial-Statements.pdf","published":null,"retrieved":"2026-09-14"},{"id":"impact25","title":"2025 impact report","publisher":"Bergen Volunteer Medical Initiative","url":"https://www.bvmi.org/wp-content/uploads/2026/07/BVMI-Impact-Report-2025.pdf","published":null,"retrieved":"2026-09-14"},{"id":"services","title":"Services, eligibility and locations","publisher":"Bergen Volunteer Medical Initiative","url":"https://www.bvmi.org/services/","published":null,"retrieved":"2026-09-14"},{"id":"finance","title":"Financial-document directory","publisher":"Bergen Volunteer Medical Initiative","url":"https://www.bvmi.org/financial-reports/","published":null,"retrieved":"2026-09-14"},{"id":"campaign","title":"Garfield expansion campaign, stale opening language","publisher":"Bergen Volunteer Medical Initiative","url":"https://www.bvmi.org/campaign-for-bvmi-unity-health/","published":null,"retrieved":"2026-09-14"},{"id":"current","title":"Current service and expansion announcement","publisher":"Bergen Volunteer Medical Initiative","url":"https://www.bvmi.org/","published":null,"retrieved":"2026-09-14"},{"id":"oregon","title":"Randomized Medicaid experiment: clinical outcomes after two years","publisher":"Baicker et al., New England Journal of Medicine","url":"https://pubmed.ncbi.nlm.nih.gov/23635051/","published":"2013-05-02","retrieved":"2026-09-14"},{"id":"donate","title":"Ordinary donation route","publisher":"Bergen Volunteer Medical Initiative","url":"https://www.bvmi.org/donate/","published":null,"retrieved":"2026-09-14"}]}