Added up, new research calculates that a physician may spend nearly three weeks a year on health plan-related tasks.
While how much of a medical practices administrative overhead can be classified as waste is still open to debate, two new Health Affairs reports attempted to put a price tag on these clerical tasks and on how much a medical practice must spend before it can extract a check from an insurance company.
In one study, University of California at San Francisco researchers calculate that the annual cost of performing billing-related tasks comes to about $85,276 per physician. In the other, Weill Cornell Medical College and the Medical Group Management Associations researchers estimate that the total cost of the nations physician-health plan interactions is somewhere between $23 billion and $31 billion.
The authors of the first study conclude that automation could be helpful in reducing claims denials, ensuring coding compliance and reducing days in accounts receivable, and that standardization of benefit plans appears to offer great potential to decrease costs. The authors of the second study note that their high-end estimate of physician-health plan interaction costs$31 billionis equal to six times the amount the federal government spends on the State Childrens Health Insurance Program.
MGMA President and CEO William Jessee, M.D., notes how the average physician works with about 12 different health plansall of which require doctors to go through slightly different credentialing procedures. He says that the study points out how repeating this process adds cost to healthcare delivery by making physicians go through the process 11 more times than necessary.
Eight percent, or one-twelfth, of the cost of credentialing is necessary, but the balance is waste that you could eliminate by using a centralized credentialing process, Jessee says. The study does point out that we really dont know where all the money goes in healthcare and how much can be saved.
Both studies were co-sponsored by the Commonwealth Fund and Robert Wood Johnson Foundation.Submit a letter to the Modern Physician Reader Blog. Please include your name, title, company and hometown. Modern Physician reserves the right to edit all submissions.