iLoveBenefits: Industry News Blog

E-health comes of age as a business issue

We need health care cost transparency … so people know how much they be expected to pay

25% of Americans have more medical debt than emergency savings

According to a survey conducted by Princeton Survey Research Associates International:

  • 55% are worried they will find themselves overwhelmed by medical debt.
  • 27% are very worried they will find themselves overwhelmed by medical debt.
  • 28% are somewhat worried they will find themselves overwhelmed by medical debt.
  • 43% are either not too worried or not worried at all about being overwhelmed with medical debt.

Note: Interviews were done in English and Spanish by Princeton Data Source from August 21 to 24, 2014.  1,006 adults living in the United States were interviewed by phone.

Source: Bankrate, Inc.

September 11, 2014 | Categories: Cost,healthcare | Tags: , , , | Comments (0)

Lower Health Care Administrative Costs

Simpler medical billing saves time, $7 billion a year
Streamlined medical billing could save four hours a week in physician time, five hours of staff time and about $7 billion a year, a study in Health Affairs said. Researchers created a billing model that involved just a single set of payment rules for multiple payers, a single claim form and standard rules of submission. United Press International (4/29)

Nearly 1 in 5 Providers Do Not Accept Credit and Debit Cards


Editor’s note: This is apparently because they don’t feel a need to do this. Is there little to no competition so that physicians feel that there is no need to provide this accommodation or convenience for their patients?

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According to a new NaviNet survey, nearly one in five doctors do not accept credit and debit cards, a common consumer payment method. High processing fees and hardware costs are the top reasons why providers do not accept credit and debit cards. Concerns over financial industry regulations are the second most popular reason for not accepting cards. Of the more than 80 percent of doctors that do accept credit and debit cards, most (87 percent) only accept these cards for their patients’ co-payments.

Source: Company Release, June 15, 2009. www.navinet.net

Is 6% a big number…all things considered?

Editor’s: So what does a private business spend on billing and collection? It would be nice to have some benchmarks to understand what 6% relates to …

 

Medical Group Practices – Cost of Billing and Insurance Related Activities

According to a Health Affairs Web Exclusive article published on May 14, 2009:

  • A total of 0.67 non-clinical FTEs were dedicated to billing and insurance-related activities per FTE physician.
  • Physicians reported spending thirty-five minutes per day interacting for required billing information, and may spend between 8-29 minutes per day recording encounter information needed for billing.
  • Other clinical staff, including nurses and medical assistants, reported spending thirty-eight minutes per day on billing/insurance activities.
  • The cost of billing and insurance-related activities performed by nonclinical personnel in 2006 was $51,221 per FTE physician–6.0 percent of operating revenue per FTE physician

Source: Julie Ann Sakowski, Jeffrey M. Newman, James G. Kahn, Richard G. Kronick, and Harold S. Luft, Peering Into The Black Box: Billing And Insurance Activities In A Medical Group, Health Affairs Web Exclusive, May 14, 2009. www.healthaffairs.org

June 1, 2009 | Categories: Cost,Economics of Health care | Tags: , , , | Comments (0)

Physician Practices Spend $31 Billion a Year on Health Insurance Plan Interaction

Editor’s note: What is absent from this story is how this compares to other businesses. For example, in the dental business what are the comparable numbers? My sense is that more dentists electronically adjudicate their claims with insurance companies reducing their time interfacing with dental plans. What about other industries outside of health care? How do auto dealers spend their time interfacing with auto makers? How about brokerage firms dealings with commodity, equity and other investment providers? 

The average physician spends nearly three weeks a year interacting with health insurance plans, at an estimated annual cost to practices of $31 billion, or $68,274 on average per physician per year, according to a study published as a Health Affairs Web Exclusive.

Costs drive patients to leave EDs without treatment

 
Editor’s note: What is interesting in this story is what is not there. In none of the stories did the author follow up and determine the consequences to the individual of leaving the emergency room. We are lead to believe that all people should take the advice of the treating physician. That what is recommended is necessary. That cost should not be part of the decision process. That somehow health care should be immune from economics. It is this psychology that is what has lead us directly into the economic malestrom in which we find ourselves. The industry dictates the prices of health care without the normal limiters on the system. 

A small but growing number of patients concerned over how they will pay their medical bills is leaving hospital emergency departments without being treated and against medical advice. Some patients also are refusing to have procedures, such as tests to confirm heart attacks, and are declining overnight hospital stays to monitor for infections. MSNBC

A Doctor’s View on Healthcare Reform

April 30, 2009

Scott Haig, M.D., says in a recent Time article that to fix healthcare we need to streamline regulation and billing, “computerize everything,” and reform malpractice.

He’s a doctor, I’m not. I am a payer, he’s not. I am an employer payer (not a health plan payer). We put insurance carriers and third party administrators in between us. While the original idea was to help manage (coordinate) care among the numerous health care delivery stakeholders, it turned into financial management. With medical inflation at two and three times general CPI who can blame a payer, it is a going out of business strategy.

We the payers need to join with the care givers, doctors in this case, to reform the system.

On regulation…we need to find a better way to make sure that best practices are created and delivered to the treating provider. This has to occur efficiently, effectively and at a cost that the patient can afford.

On billing…a single ‘plan’ conjures up the notion of Medicare like reimbursement. Leverage on physicians to drive down their reimbursements. We need value creation on the part of the providers for which payers pay differentially based on the demonstrated value of the service.

On computerization…the advent of computerization in every other venue has driven productivity, consistency, lean processes and high quality transactions. The notion here isn’t to simply computerize everything, but rather to use computer systems as a tool. But that tool should only be implemented once the processes are re-engineered to take best advantage of the computer application(s).

On malpractice…there is little doubt the system must be reformed. As in any large group there are better and poorer performers. There needs to be a real process to identify and weed out poorer performers. Then there must be a change in how accountability is shared across the system of providers so that the patient is at the center and a designated provider take full accountability for coordinating total care of the patient throughout an episode — whether that is preventive, acute or chronic.