Monday, May 18, 2009

Talking with Health Plans Costs Big Bucks

Does anyone NOT think we need health care reform? A study published in Health Affairs and funded by the Commonwealth fund and the Robert Woods Johnson Foundation found that physician practices spend $31 billion annually just "interacting" with Insurance plans.

As one who as been on the "interaction" side for most of my professional life, I can tell you those numbers are probably underestimates. The time spent on prior authorizations, pharmaceutical formularies, claims, billing, contracting, collecting data and just being on hold is what has killed primary care in the United States. Doctors are bailing out by leaving patient care, going concierge (retainer) or not taking insurance at all.

This leaves more patients footing the entire bill or not able to find a primary care doctor at all.

This is a system that is entirely out of wack. By forcing physicians to deal with multiple insurance carriers, each with their own payment schedules, formularies, credentialing and claim forms, we are perpetuating waste and inefficiency and it does nothing to advance the health of Americans.

Health care reform must address insurance related administration activities. Single payer is looking better and better.


Anonymous said...

And that doesn't begin to estimate the amount of time I spend with my insurance company trying to get them to pay for treatment after I have faithfully paid my premium for years. Out with the crooks!

Raymond Bouchayer said...

Good comments Dr.Toni . I have always said that our taxes should pay for things like this instead of embarking into crusades that kills , injures and end up costing us ...the taxpayer more money .
Lets get those Insurance companies out of health Insurance , Period .

Physician disability insurance said...

Wow $31 billion? This is just another example of the need for reform, and the need for physicians to protect their assets and income.

Jenn said...

I still think high deductible plans with no need for patients to run the bill through the insurance company (just submit receipts once they've reached the deductible and are ready for insurance to kick in) is the way to go...having a third party pay for routine care just increases the cost--whether it is a single third party payor, or the assorted mis-mash we have now.

Not only does running every bill through the insurance company raise the cost, but taking the current system makes the consumer un-aware of costs, and I think then more likely to over-use health care.

jenny said...
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