The electronic medical record has gotten a lot of popular attention from politicians who want a simple answer to the high costs of medical care in this country. But what they don't often talk about is the price tag associated with a reimbursement system that requires providers to deal with multiple payers using different systems to "control" costs.
In some states, a medical practice's business office may have to be set up to submit and follow up on bills to as many as 10 insurers. Since all these plans have different rules and processing systems, the AMA says, physicians spend 14 percent of their total revenue just to collect what they've earned. Add the provider back office costs to the managed care costs imposed by the companies who pay the bills, and is it any wonder advocates of a single payer plan say it would be cheaper in the long run?
The AMA released a study today that rates the insurors for how transparent and efficient their payment processes are. Shocking, I know, that the company with the most lax control over executive compensation was also rated lowest by the AMA for how well its payments to providers matched up with contract terms.
UnitedHealthcare had the lowest rate of contract compliance, according to the AMA report. About 62 percent of medical services billed were paid by UnitedHealthcare at the contracted rate, compared with 71 percent for Aetna and 98 percent for Medicare.
— "Physicians grade health insurers," Star Tribune
Medicare, that dreaded government program, performed better than the private insurers in most areas.
