Thursday, April 14, 2016

Healthcare Only A Bureaucrat Can Love

Government agencies and insurance companies love numbers. They hire armies of statisticians and accountants to pore over the millions of numbers generated by the healthcare industry. They then focus on the specific measures that they feel will help them save money. These become the core quality metrics that are used to judge a physician's competence and compensate accordingly. What initially started as guidelines to improve patient care have become bludgeons to force physicians to practice medicine as bureaucrats see fit.

Whereas in the past a physician's reimbursement might be rewarded with a bonus for following quality metrics, the new payment models punish doctors if they don't follow these rules. Therefore in order to make sure they comply with all these rules, doctors now have to spend an inordinate amount of time and money to document their compliance. In an article published in Health Affairs, researchers calculate that it costs the healthcare system $15.4 billion just to make sure they are following the quality metrics. They estimate that each physician spends fifteen hours per week documenting their activities just for the payers' benefits. This works out to about $40,000 per year per physician of wasted productivity doing nothing but charting into a computer for some faceless agent to decide whether the doctor will be given his proper reimbursement. 

The winners in all this? Certainly not the patients who are unlikely to receive medical care that is substantially improved compared to before this mess. Nor is it the doctors who have become just another arm of the true overlords of the medical industry, the health insurance companies. The payers have become the judge and jury in how healthcare is delivered in this country. They can and will change how these quality measures are supposed to work to their own financial benefit. 

Another winner? If you're looking for a job in a high growth field, perhaps consider going into medical transcription. With all the new computer charting that needs to be done to be in compliance with these rules, medical transcribers are projected to grow from a current number of 15,000 to 100,000 by the year 2020 according to the American College of Medical Scribe Specialists.

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