How Large a Problem are Provider Administrative Costs in Health Care?

Healthcare provider burnout has been worsening in recent years, and one of the major drivers is increased required data entry. Provider burden has become so bad that nearly 70% of doctors say they would not recommend the profession to young people considering the medical field.

While most people think of EHRs driving burnout, having to provide basic provider information to multiple payers can also add unnecessary burden to providers staff.

New studies show that the overall paperwork burden on physicians is worse than ever. And this burden impacts costs and quality of care.

EHRs- Good intentions; disastrous results for providers and patients?

Much of today’s crushing paperwork burden comes from the last 10 years’ push for implementing electronic health records (EHR) systems. According to the most recent Physicians Foundation survey, 86% of physicians have experienced an increased regulatory burden in the last year.

Back in 2009, the economic stimulus package signed by President Obama established the “meaningful use” requirements for doctors to continue receiving same-level payments from Medicare and Medicaid. Nearly 10 years later, 40% of doctors says EHRs have been a disaster and are a driving force in their overall job dis-satisfaction. More than half of providers say EHRs increase cost, but only 10% say they save money.

Almost 2/3rds of doctors say EHRs have taken away time they used to spend with patients. One study showed that for every hour a doctor spends with patients, they spend 2 hours on EHR and other documentation. While the intended result of the meaningful use and EHR push may have been improved quality for patients and reduced cost, a majority of doctors say it actually made problems worse. Much worse.

Besides the negative impacts of burnout on providers themselves, all this focus on administrative tasks works against key efforts in the Medicaid program. Most Medicaid programs have been attempting to implement value-based payment systems in recent years. It’s hard for physicians to see the promise of quality-based incentive systems when $54B a year is now spent on dealing with billing complexities just for outpatient visits.

Physicians consistently list Medicaid payment policies as the most complex of all. And when Medicaid becomes too much trouble to deal with, another key Medicaid program goal – the provider participation rate- suffers. While many think tanks and program officials gloss over (or understate) the exodus of doctors from Medicaid networks, about 30% of doctors now refuse to accept any new Medicaid patients. In some states its as high as 60%.

Promising efforts to reduce the administrative burden

EHRs are the focus of recent studies, but other types of paperwork burden impact your networked providers, too. Prior authorization tasks have increased according to most physicians surveyed. Getting hit with multiple requests for basic information from payers (as part of ongoing credentialing efforts) just adds to the burden if not done efficiently.

Fortunately for providers, the new CMS administration understands the burden created by the EHR push and is working to reduce it. The new rule for Medicare payments (commonly called the Patients Over Paperwork effort) includes provisions to streamline provider documentation requirements. It also removes 105 (out of 416) quality measures deemed to not add value to patient care. All told, the new rule is estimated to save providers $5B and 53 million hours by 2012. That’s 53M hours they can now go back to spending with patients.

There are also new efforts to improve the efficiency of credentialing. While each state has its own approach to credentialing, some states have started to simplify their processes. Texas has an alliance of state officials, the state medical association and the Texas Association of Health Plans. Their efforts are focused on reducing tasks providers have when applying for different health plan networks. The time savings for each provider can be significant- there are 19 Medicaid health plans in Texas.

Want to reduce provider burden in your network?

While the size and intensity of provider administrative burden can seem overwhelmingly, one place you can start to reduce the burden on your providers is in the credentialing process. To learn more about what Paragon can do to help, contact us online or by phone.

Further reading

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