Too Much Paperwork

by Don Jewler, Director of Communications, ACCC

Are you drowning in paperwork? Compared to healthcare providers in Canada, many physicians and nurses in the United States are spending much more time interacting with health plans and submitting claims. That was the conclusion of a new study published in the August issue of Health Affairs.

On average, according to study results, U.S. doctors spent 3.4 hours per week interacting with health plans while doctors in Ontario spent about 2.2 hours. Nurses and medical assistants, spent 20.6 hours per physician per week on administrative duties compared to their Canadian counterparts, who only spent 2.5 hours.

According to the article, most of the difference stems from the fact that Canadian physicians deal with a single payer, in contrast to the multiple payers in the United States. Obtaining prior authorizations takes a lot of our time.
Study authors point out that high administrative costs in the United States are due to the fact that different payers have different plan requirements, insurance formularies, and rules for billing and claims submission. Conversely, Canadian physicians generally interact with a single payer that offers one product and more streamlined procedures for reporting and payment.

Among oncology private practices, previous studies have estimated administrative cost to be 27% of annual physician revenue.¹ Insurance- and billing-related costs are estimated to be 14% of annual practice revenue.² (As quoted in a 2009 ASCO study.)

Can you recoup for time spent on claims, appeals, requests for additional documentation, insurance enrollment, and credentialing forms? Most likely not. However, in some instances, there may be ways to secure reimbursement for your time, although a number of laws and requirements get in the way. A new article in Oncology Issues, July/August 2011, page 13-14, provides some answers.

References
¹ Angrisano C, Farell D, Kocher B, et al. (2007) Accounting for the Cost of Health Care in the United States (McKinsey & Company), pp 70–85.
² Kahn JG, Kronick R, Kreger M, et al. (2005) The cost of health insurance administration in California: Estimates for insurers, physicians, and hospitals. Health Aff (Millwood) 24:1629–1635.