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.
Posted by Toni Brayer, MD at 10:31 PM