Reducing Costs With Improved Efficiency

An essential part of any health care reform is finding ways to reduce health care costs by improving efficiencies without sacrificing patient care.  Health Information Technology (HIT) offers us a way to achieve both.    

A large contributor to high costs is the massive amount of money the healthcare industry spends on paperwork for Medicare and private insurance billing.  There have been studies that show upwards of 21 to 31 percent of all the money we spend on health care in the U.S. is spent on paperwork and regulations.  Talk to your doctor and hospital about how many people they must employ to fill out forms, and you will be amazed.

HIT provides us with a method to reduce the burden and duplication that shuffling paper imposes on doctors and hospitals.  However, an important part of implementing HIT centers on the interoperability of digital health records from one hospital to another.  I believe the simplification and standardization of forms would go a long way in aiding this process.        

I have introduced a bill that establishes a Commission on Billing Codes and Forms Simplification that is tasked with working with Medicare and the medical community to standardize and simplify billing practices while protecting patient privacy.  The goal is not a federal mandate to use a certain form but an industry standard that would be widely accepted.  The Commission would also study electronic forms and billing practices with the same goals in mind.  This measure takes a practical approach by establishing pilot programs to work out the details with doctors, insurance companies, and government agencies before system-wide changes are implemented.

Congressman Mac Thornberry became a Member of Congress in 1995 and first introduced the “Health Care Paperwork Reduction and Fraud Prevention Act” in 2001.  He has introduced four other health care bills in the 111^th Congress.

Comments

[Kris, the office Manager]

My husband is a solo Orthopedic surgeon - I am the office manager and I do coding and billing. We have used an Electronic MEdical Record system with E-PRescribing since 2007. It is a difficult transition but well worth the investment in dollars and time. Re Insurance regulation, we like to say it is a rigged game-the rules change constantly. Regulations imposed through the Medicare system ( your federal tax dollars in action) are basically the industry standards . Whatever MEdicare decides, all follow domino-style eventually. IF you can manage to keep ahead of the game on the rules & regs AND you submit and receive electronically, you will "probably" be able to stay afloat. We average about $.45 return for each dollar billed, and that is due to contractual amounts, not to any ineffeciency on our part.
RE the massive papaer requirements due to regulations - We have noted that for an elective surgery, the pages we submit to the hospital required to just schedule the event number ,at a minimum, 50 pages. That is to START the process. The completed MEdical record post discharge numbers in the 100's. SOME of this relates, of course,to malpractice defense. The balance relates to documentation "support" required for billing- to prove that fraud is not your intent. It is all very demoralizing. We ( my husband and I ) have been in the medical field in some form or another for 30 plus years. We like what we do, but the environment is hostile and getting through each day has become a marathon. If all we had to do was provide good patient care, that would be easy. If you don't mind, I would prefer to remain anonymous but I would answer questions about daily medical practice life to further the cause of good medical care.