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Pensacola News Journal: Insurance paperwork threatens healthcare as much as costs

The U.S. healthcare system is a sprawling network of payers, middle men, suppliers and third-parties, all trying to devise new and more complex ways to reduce their losses. Meanwhile, the cost of their profit-driven procedures increasingly falls on doctors, who now spend more time filling out paperwork than caring for patients. As state and federal lawmakers debate how to overhaul healthcare, they should demand that the insurance industry agree on some simple reforms to allow the doctor-patient relationship to foster.

In just the last four years, bureaucratic paperwork has contributed to a 25 percent increase in physician burnout. As a doctor, I have seen how more and more time is taken up with duplicative forms, redundant paperwork and unnecessary procedural rules, all of which have grown in direct proportion to the complexity of today’s health insurance plans.

The average doctor today must participate in at least a dozen managed care plans just to stay competitive. This dozen or so does not include Medicare or the 50 independently-administered state Medicaid programs. All of these parties come with their own forms and filing procedures, and all can change at any moment.

Most of my colleagues wanted to be doctors because they had a strong desire to help heal the sick and alleviate the suffering. Yet, like me, they now spend more time reading procedural rules and entering routine data than diagnosing illness or comforting patients. The American College of Physicians (ACP) estimates that the average doctor now does two hours of administrative “desk” work for every hour spent interacting with patients.

There has never been more administration involved in the practice of medicine than there is today. The share of a physician’s workload dedicated to filling out forms has grown substantially with the proliferation and complexity of managed health plans. Although proving a direct link is difficult, we know for certain that the percent of total U.S. healthcare spending devoted to administrative costs doubled between 1980 and 2010, which was also the time when America embraced managed healthcare for the first time.

Paperwork costs doctors far more than the extra administrative burden. On average, a doctor spends anywhere from $68,000 to $85,000 a year (about 14 percent of total revenue, or almost one-third of a primary care physician’s salary) on billing and insurance company issues, according to an ACP estimate. Collectively, the paperwork burden comprises about 18 percent of the nation’s total healthcare spending. In other words, if we could find more efficient methods for providing care, they could reduce total healthcare costs by almost one-fifth.

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There are any number of solutions that insurers could implement to help simplify paperwork and reduce redundancy. They could give doctors uniform (and accurate) estimates of patient cost-sharing liability at the time of service. They could standardize administrative record systems, harmonize electronic claim submission forms and homogenize provider enrollment and credentialing systems. To streamline billing and payment procedures, insurers could adopt a unique identifier for all health plans and establish uniform standards for payments by electronic funds transfer.

Health insurance companies claim to be so efficient yet they repeatedly ignore some obvious solutions to the growing administrative burden that seems to value paperwork before patients. Politicians, patients and providers should get their attention by using the current healthcare overhaul to demand that the industry adopt some common-sense reforms and give America’s doctors a break.

Dr. Benjamin Kaplan is an internal medicine physician with Orlando Health and has been in practice for almost 10 years.

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