Billions Wasted on Billing

[n2doc]

By EZEKIEL J. EMANUEL

LAST year I had to have a minor biopsy. Every time I went in for an appointment, I had to fill out a form requiring my name, address, insurance information, emergency contact person, vaccination history, previous surgical history and current medical problems, medications and allergies. I must have done it four times in just three days. Then, after my procedure, I received bills — and, even more annoying, statements of charges that said they weren’t bills — almost daily, from the hospital, the surgeon, the primary care doctor, the insurance company.

Imagine that repeated millions of times daily and you have one of the biggest money wasters in our health care system. Administration accounts for roughly 14 percent of what the United States spends on health care, or about $360 billion per year. About half of all administrative costs — $163 billion in 2009 — are borne by Medicare, Medicaid and insurance companies. The other half pays for the legions employed by doctors and hospitals to fill out billing forms, keep records, apply for credentials and perform the myriad other administrative functions associated with health care.

The range of expert opinions on how much of this could be saved goes as high as $180 billion, or half of current expenditures. But a more conservative and reasonable estimate comes from David Cutler, an economist at Harvard, who calculates that for the whole system — for insurers as well as doctors and hospitals — electronic billing and credentialing could save $32 billion a year. And United Health comes to a similar estimate, with 20 percent of savings going to the government, 50 percent to physicians and hospitals and 30 percent to insurers. For health care cuts to matter, they have to be above 1 percent of total costs, or $26 billion a year, and this conservative estimate certainly meets that threshold.

How do we get to these savings? First, electronic health records would eliminate the need to fill out the same forms over and over. An electronic credentialing system shared by all hospitals, insurance companies, Medicare, Medicaid, state licensing boards and other government agencies, like the Drug Enforcement Administration, could reduce much of the paperwork doctors are responsible for that patients never see. Requiring all parties to use electronic health records and an online system for physician credentialing would reduce frustration and save billions.

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http://opinionator.blogs.nytimes.com/2011/11/12/billions-wasted-on-billing/?ref=opinion

[valerief]

1. the upside, of course, is that it creates jobs, but they're probably not in the US. nt

[postulater]

2. Electronics are not the answer

That's just a diversion from the real solution which is single payer.

Are we any closer now that Medicare is cutting doctor fees 27%?

[RC]

3. Another reason for Single Payer, Universal Health Care

[Scuba]

5. Bingo.

[TBF]

4. I agree- it shows how much we need single payer health care. nt

[KT2000]

6. You bet

when my referral took over two months to be approved, how many times was justification submitted to the insurance company only to be thrown in the trash. How about the number of times the pharmacist has to go around and around with the doctor and the insurance company to get a prescription the ins. co will cover. Doctors have had to hire extra full-time help just to deal with the insurance companies.

[WCGreen]

7. Totally agree....

I am lucky, my three main doctors set up a corporation so that I am billed by one company and my information is accessible for all the doctors in the system...

Here in Cleveland, the Clinic has a great billing system that itemizes and is printed on only one statement per month. It takes me about 30-45 min a month to match up my bills to the Medicare and private insurance. It's easy and saves a ton of money...