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What are the costs to physicians of administrative complexity in their interactions with payers?
1Changes in Health Care Financing & Organziation (HCFO), USA. jenny.minott@academyhealth.org
Insights
Physicians face increasing administrative burdens, particularly primary care doctors and those in small practices. The annual cost for physician practices interacting with health plans totals $31 billion.
Area of Science:
- Health Services Research
- Medical Economics
- Physician Practice Management
Background:
- Administrative tasks represent a significant portion of physician workload.
- Interactions with health plans contribute substantially to practice overhead.
- Understanding the financial and time costs of administrative burdens is crucial for healthcare policy.
Purpose of the Study:
- To quantify the time and financial costs associated with administrative tasks for physicians.
- To identify which physician groups and practice types bear the heaviest administrative burden.
- To assess the trend in administrative burden related to health plan interactions.
Main Methods:
- Survey data collected from physicians and practice administrators.
- Analysis of time spent on administrative tasks by physician specialty and practice size.
- Calculation of per-physician and total national costs for health plan interactions.
Main Results:
- Primary care physicians dedicate more time to administrative duties than specialists.
- Smaller practices (1-2 physicians) experience higher administrative burdens compared to larger ones.
- Over 75% of practices reported increased administrative burden from health plans in the last two years.
- Physician practices incur an average annual cost of $68,274 per physician for health plan interactions, totaling $31 billion nationally.
Conclusions:
- Administrative tasks, especially those involving health plans, pose a significant and growing challenge to physician practices.
- The findings highlight potential areas for policy intervention to reduce administrative inefficiencies and costs.
- Reducing administrative burdens could improve physician satisfaction and potentially patient care access.
Key Findings:
(1) Primary care physicians spent significantly more time on administrative tasks than did medical specialists or surgical specialists. (2) All staff in physician practices with one or two physicians spent more time on administrative tasks than did physicians and staff in practices with more than 10 physicians. (3) More than 75 percent of physicians and administrators reported that the administrative burden of interacting with a health plan increased significantly or increased slightly in the past two years. (4) On average, physician practices spent $68,274 per physician per year interacting with health plans. When this average is multiplied by the number of physicians practicing in the United States, the total cost of physicians' interactions with health plans is $31.0 billion.
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