Administrative costs associated with physician billing and insurance-related activities at an academic health care system

JAMA - Journal of the American Medical Association

Volumn 319, Issue 7, 2018, Pages 691-697

  Tseng, Phillip ^a   Kaplan, Robert S ^b   Richman, Barak D ^c   Shah, Mahek A ^b   Schulman, Kevin A ^b,d  

^a DUKE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b HARVARD BUSINESS SCHOOL   (United States)

^c DUKE UNIVERSITY   (United States)

^d DUKE CLINICAL RESEARCH INSTITUTE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADMINISTRATIVE COST; ADMINISTRATIVE PERSONNEL; AMBULATORY SURGERY; ARTICLE; ELECTRONIC HEALTH RECORD; HEALTH CARE COST; HEALTH INSURANCE; HEALTH SERVICE; HOSPITAL BILLING; HOSPITAL DISCHARGE; HOSPITALIZATION; HUMAN; INSURANCE; PHYSICIAN; PRIMARY MEDICAL CARE; PRIORITY JOURNAL; TIME; UNITED STATES; UNIVERSITY HOSPITAL; COST; ECONOMICS; ELECTRONIC MEDICAL RECORD SYSTEM; MANAGEMENT; NONBIOLOGICAL MODEL; ORGANIZATION AND MANAGEMENT; STATISTICS AND NUMERICAL DATA; TASK PERFORMANCE; TIME FACTOR;

ACADEMIC MEDICAL CENTERS; COSTS AND COST ANALYSIS; HEALTH CARE COSTS; INSURANCE, HEALTH; MEDICAL RECORDS SYSTEMS, COMPUTERIZED; MODELS, ORGANIZATIONAL; PRACTICE MANAGEMENT, MEDICAL; TASK PERFORMANCE AND ANALYSIS; TIME FACTORS;

EID: 85042255566     PISSN: 00987484     EISSN: 15383598     Source Type: Journal    
DOI: 10.1001/jama.2017.19148     Document Type: Article

References (37)

1. Himmelstein DU, Jun M, Busse R, et al. A comparison of hospital administrative costs in eight nations: US costs exceed all others by far. Health Aff (Millwood). 2014;33(9):1586-1594.
2. Jiwani A, Himmelstein D, Woolhandler S, Kahn JG. Billing and insurance-related administrative costs in United States' health care: synthesis of micro-costing evidence. BMC Health Serv Res. 2014;14(1):556.
3. Woolhandler S, Campbell T, Himmelstein DU. Costs of health care administration in the United States and Canada. N Engl J Med. 2003;349(8): 768-775.
4. Morra D, Nicholson S, LevinsonW, Gans DN, Hammons T, Casalino LP. US physician practices versus Canadians: spending nearly four times as much money interacting with payers. Health Aff (Millwood). 2011;30(8):1443-1450.
5. Berwick DM, Hackbarth AD. Eliminating waste in US health care. JAMA. 2012;307(14):1513-1516.
6. Kahn JG, Kronick R, Kreger M, Gans DN. The cost of health insurance administration in California: Estimates for insurers, physicians, and hospitals. Health Aff (Millwood). 2005;24(6):1629-1639.
7. Blanchfield BB, Heffernan JL, Osgood B, Sheehan RR, Meyer GS. Saving billions of dollars-And physicians' time-by streamlining billing practices. Health Aff (Millwood). 2010;29(6): 1248-1254.
8. Casalino LP, Nicholson S, Gans DN, et al. What does it cost physician practices to interact with health insurance plans? Health Aff (Millwood). 2009;28(4):w533-w543.
9. Sakowski JA, Kahn JG, Kronick RG, Newman JM, Luft HS. Peering into the black box: billing and insurance activities in a medical group. Health Aff (Millwood). 2009;28(4):w544-w554.
10. HealthIT.gov. What are the advantages of electronic health records? https://www.healthit.gov/providers-professionals/faqs/what-Are-Advantages-electronic-health-records. Accessed September 13, 2017.
11. Kaplan RS. Improving value with TDABC. Healthc Financ Manage. 2014;68(6):76-83.
12. Kaplan RS, Anderson SR. Time-driven activity-based costing. Harv Bus Rev. 2004;82(11):131-138, 150.
13. Kaplan RS, Porter ME. How to solve the cost crisis in health care. Harv Bus Rev. 2011;89(9):46-52, 54, 56-61 passim.
14. French KE, Guzman AB, Rubio AC, Frenzel JC, Feeley TW. Value based care and bundled payments: Anesthesia care costs for outpatient oncology surgery using time-driven activity-based costing. Healthc (Amst). 2016;4(3):173-180.
15. DiGioia AM III, Greenhouse PK, Giarrusso ML, Kress JM. Determining the true cost to deliver total hip and knee arthroplasty over the full cycle of care: preparing for bundling and reference-based pricing. J Arthroplasty. 2016;31(1):1-6.
16. Haas DA, Kaplan RS. Variation in the cost of care for primary total knee arthroplasties. Arthroplast Today. 2016;3(1):33-37.
17. Haas DA, Bozic KJ, DiGioia AM, Song Z, Kaplan RS. Drivers of the variation in prosthetic implant purchase prices for total knee and total hip arthroplasties. J Arthroplasty. 2017;32(2):347-350.e3.
18. Kaplan RS, Greenhouse P, DiGioia A. To reconcile mission and margin, deliver better outcomes at lower costs. Orthop Today. 2013;33 (12):20.
19. Anzai Y, Heilbrun ME, Haas D, et al. Dissecting costs of CT study: Application of TDABC (time-driven activity-based costing) in a tertiary academic center. Acad Radiol. 2017;24(2):200-208.
20. Oklu R, Haas D, Kaplan RS, et al. Time-driven activity-based costing in IR. J Vasc Interv Radiol. 2015;26(12):1827-1831.
21. Najjar PA, Strickland M, Kaplan RS. Time-driven activity-based costing for surgical episodes. JAMA Surg. 2017;152(1):96-97.
22. McLaughlin N, BurkeMA, Setlur NP, et al. Time-driven activity-based costing: A driver for provider engagement in costing activities and redesign initiatives. Neurosurg Focus. 2014;37(5):E3.
23. Thaker NG, Pugh TJ, Mahmood U, et al. Defining the value framework for prostate brachytherapy using patient-centered outcome metrics and time-driven activity-based costing. Brachytherapy. 2016;15(3):274-282.
24. Thaker NG, Frank SJ, Feeley TW. Comparative costs of advanced proton and photon radiation therapies: lessons from time-driven activity-based costing in head and neck cancer. J Comp Eff Res. 2015;4(4):297-301.
25. Thaker NG, Ali TN, Porter ME, Feeley TW, Kaplan RS, Frank SJ. Communicating value in health care using radar charts: A case study of prostate cancer. J Oncol Pract. 2016;12(9):813-820.
26. Yun BJ, Prabhakar AM, Warsh J, et al. Time-driven activity-based costing in emergency medicine. Ann Emerg Med. 2016;67(6):765-772.
27. Erhun F, Mistry B, Platchek T, Milstein A, Narayanan VG, Kaplan RS. Time-driven activity-based costing of multivessel coronary artery bypass grafting across national boundaries to identify improvement opportunities: study protocol. BMJ Open. 2015;5(8):e008765.
28. Kaplan RS, Haas DA, Warsh J. Adding value by talking more. N Engl J Med. 2016;375(20):1918-1920.
29. Warsh J, Nurok M. Allies, not adversaries: partnering with clinicians in the value revolution. NEJM Catalyst. http://catalyst.nejm.org/allies-not-Adversaries-clinicians-value-revolution. Published October 4, 2016. Accessed June 22, 2017.
30. Hanson GJ, Haas D, Kuchera DD, Sobolik GJ, Helmers RA, Kaplan RS. TDABC in primary care: Results of a Harvard/Mayo Clinic collaboration. HFM Magazine. 2016;70(7):34-42.
31. Medical Group Management Association. 2017 MGMA DataDive Provider Compensation: Academic Compensation. Englewood, CO: Medical Group Management Association; 2017.
32. American Academy of Family Physicians. Lifestyle & income in family medicine. http://www.aafp.org/medical-school-residency/choosing-fm/lifestyle.html. Accessed June 19, 2017.
33. American Academy of Family Physicians. Table 8: Average number of hours worked per week by family physicians by task (as of December 2015). http://www.aafp.org/about/the-Aafp/family-medicine-facts/table-8.html Accessed January 22, 2018.
34. Leigh JP, Tancredi D, Jerant A, Kravitz RL. Annual work hours across physician specialties. Arch Intern Med. 2011;171(13):1211-1213.
35. 8 Epic EHR implementations with the biggest price tags in 2015. Becker's Health IT & CIO Review. http://www.beckershospitalreview.com/healthcare-information-Technology/8-epic-ehr-implementations-with-The-biggest-price-Tags-in-2015.html. Published July 1, 2015. Accessed June 15, 2017.
36. Internal Revenue Service. Publication 946: Cat No. 13081F: how to depreciate property. https://www.irs.gov/pub/irs-pdf/p946.pdf. Published February 27, 2017. Accessed January 22, 2018.
37. De Pietro C, Camenzind P, Sturny I, et al. Switzerland: health systemreview. Health Syst Transit. 2015;17(4):1-288, xix.