Posts Tagged ‘standardized medical billing’

Healthcare Leaders Prefer Standardized Payments

Thursday, November 11th, 2010

71 percent of healthcare leaders support standardized payment system.  It seems as if the only way to control rising healthcare costs is to create a standardized payment structure.  This is the primary finding of the 22nd Commonwealth Fund/Modern Healthcare Opinion Leaders survey, which studied disclosure and pricing in the healthcare industry.  More than two-thirds of the 190 individuals who responded to the survey – fully 71 percent – said it is “very important” or “important” that “all payers use the same basic method of payment for rewarding quality and efficiency.”

Just 12 percent of survey respondents don’t believe that a standardized payment structure will impact the quality and efficiency of healthcare.  All groups of survey respondents strongly supported the perception of a common payment structure for private insurers.  Fully 72 percent of respondents representing academia and research institutes voiced support for the concept, compared with 79 percent from healthcare delivery organizations, as well as 77 percent form insurers and other health businesses.  A total of 54 percent favor the concept.

Commenting on the study, Louise Probst, Executive Director of the St. Louis Area Business Health Coalition, saidWe all know the drill. The American healthcare system seriously underperforms when compared with the health systems of every other industrialized nation.  As a result, each year, large numbers of Americans are harmed or die unnecessarily.  In fact, since the Institute of Medicine’s (IOM) executive summary to its landmark report To Err Is Human was published in the Journal of American Medical Association in September 1999, additional research has only confirmed its findings.  A decade later, the IOM estimate that up to 30 percent of all healthcare expenditures pay for care with little or no health benefit fails to shock. Experts now project that 40 percent or more of all spending has little or no benefit.  Meanwhile, the average cost of health insurance for a family of four has grown to more than $14,000 annually.”

Standardized Medical Billing Could Save $7 Billion a Year

Wednesday, May 19th, 2010

Physicians could save $7 billion a year if insurers standardized medical billing procedures.  If healthcare insurance companies created a standardized billing system, it could cut physician office administrative costs by $7 billion a year, according to a study published in Health Affairs. Standardizing medical billing would assure transparency, as well as create a single claim submission deadline and payment posting rules.

That estimate is based on a 2006 analysis of the labor and overhead costs required to process health insurance benefits and claims at one large academic physician group practice.  According to the study, the physician group could hypothetically save $44 million if it processed all benefits and claims using Medicare payment rules.  Paperwork and follow-up with insurers totaled $33.1 million, while office labor and overhead ate up an additional $5.6 million that could be saved with standardized billing procedures.

According to the study’s authors, “The U.S. system of billing third parties for healthcare services is complex, expensive, and inefficient.  Physicians end up using nearly 12 percent of their net patient service revenue to cover the costs of excessive administrative complexity.  A single transparent set of payment rules for multiple payers, a single claim form, and standard rules of submission, among other innovations, would reduce the burden on the billing offices of physician organizations.  On a national scale, our hypothetical modeling of these changes would translate into $7 billion of savings annually for physician and clinical services.  Four hours of professional time per physician and five hours of practice support staff time could be saved each week.”