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Financial view of healthcare
Posted on 1/30/18 at 7:42 am
Posted on 1/30/18 at 7:42 am
I do not this to be a political discussion but more of a financial discussion of healthcare (I know the two are not mutually exclusive).
I work in the healthcare field, so I likely have a slightly warped opinion. My opinion is that paperwork and administrative overhead has ballooned to an uncontrollable level. We literally spend 2 -10x administrative costs as other countries. I feel this is an area that is rarely discussed as an area for reform.
There has been significant decrease in physician reimbursement, significant decrease of industry spending, but costs keep escalating. I blame this mostly on administrative redundancy.
What are some opinions on this from people not involved in the field? Is it your view that practitioners (doctors, NPs,PAs) are the main money makers in the system? Do you think the paperwork involved in medicine is archaic and redundant?
I work in the healthcare field, so I likely have a slightly warped opinion. My opinion is that paperwork and administrative overhead has ballooned to an uncontrollable level. We literally spend 2 -10x administrative costs as other countries. I feel this is an area that is rarely discussed as an area for reform.
There has been significant decrease in physician reimbursement, significant decrease of industry spending, but costs keep escalating. I blame this mostly on administrative redundancy.
What are some opinions on this from people not involved in the field? Is it your view that practitioners (doctors, NPs,PAs) are the main money makers in the system? Do you think the paperwork involved in medicine is archaic and redundant?
5
Posted on 1/30/18 at 7:49 am to GeauxTigers777
quote:
Insurance companies are the main money makers in the system
Posted on 1/30/18 at 8:12 am to GeauxTigers777
Just like any industry that the government starts to get heavily involved in, it becomes less efficient and more expensive.
That's not politics, that's a fact.
That's not politics, that's a fact.
Posted on 1/30/18 at 9:35 am to GeauxTigers777
quote:
My opinion is that paperwork and administrative overhead has ballooned to an uncontrollable level. We literally spend 2 -10x administrative costs as other countries. I feel this is an area that is rarely discussed as an area for reform.
What exact role are you in? I've never met a doctor/NP/PA etc that doesn't think the required documentation to actually get paid for services rendered are ridiculous. Administrative redundancy isn't causing decreases in reimbursements. Insurance is. MCO'S, PPO's, or reimbursements based on RVUS and the medicare conversion factor will all reimburse the same exact procedures at different levels. And that is complicated by the payer mix of patient demographics in different locations. shite half the time the accountants don't agree with upper management on how much total revenue will actually be in 6-9 months later based on accrual numbers. I could write 4 paragraphs on just that.
What about the paperwork and documentation do you find so archaic and redundant and what would you do to change it?
Posted on 1/30/18 at 9:51 am to GeauxTigers777
This post was edited on 1/30/18 at 9:52 am
Posted on 1/30/18 at 10:02 am to the_watcher
quote:
What about the paperwork and documentation do you find so archaic and redundant and what would you do to change it?
Well some of it's institutional based and not applicable to every hospital. I'm sure most people have some form of redundancy they encounter at their institution.
For instance my institution,
For a 10min ear tube case I have to:
- have an updated h&p within the last 30 days(sorry it took me 6 weeks to get the OR)
- have a separate day of surgery note that references the aforementioned h&p
- have an immediate brief op note that must be place before I leave the OR
- have a dictated op report within 24h
- have a discharge summary note for that 10min case
- do the med recc as well even though theres no Rx I'm providing during this encounter
- separate d/c instructions for each pt(no handouts).
It takes me longer to do all of this paper work than it does to do the actually case.
Posted on 1/30/18 at 10:33 am to GeauxTigers777
If the health insurance companies didn't work so hard to deny claims, medical providers probably wouldn't have to work so hard to process them correctly for payment.
Posted on 1/30/18 at 11:04 am to Puffoluffagus
quote:
For a 10min ear tube case I have to:
So you are a physician. Have you ever sat down with an administrator and had them explain exactly how you get paid? That is, the entire process of a coder using your documentation to code for the procedure, then the biller sending off the required forms to the third party insurer regardless of who that third party insurer is? Have you ever seen the actual cash tables (normally in pivot table form) that break out each payer class by amount money charged relative to the amount of actual cash and percentage that has been paid on those claims?
I'm not being condescending at all. Most doctors haven't. What about a case where a claim is denied. Or improperly coded. Or falsely denied. Know what happens then? All of the documentation you hate (and deservedly so I get it) is now the only thing existing that will allow you to get reimbursed.
What about a frivolous malpractice suit? Guess what is going to easily save you ten times out of ten? Detailed documentation. Does it suck that it's required? Of course. But it's better than the alternative. As is having all that documentation available in case of a future medical emergency that you are not present for.
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