CMWF-U.S. Physician Practices Spend Nearly Four Times as Much Money Interacting with Health Plans & Payers

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In this Health Affairs article, sponsored by the Commonwealth Fund, the authors found these key findings:

  • Physician practices in the United States spent $82,975 per physician per year interacting with payers, compared with $22,205 in Ontario.
  • If U.S. physicians had administrative costs similar to those of Ontario physicians, their total savings would be approximately $27.6 billion per year.
  • In the U.S., nurses and medical assistants spent 20.6 hours per physician per week on administrative tasks related to health plans, nearly 10 times the 2.5 hours spent by Canadian nursing staff. U.S. nursing staff spent more time in every category of interactions, most notably obtaining prior authorizations, which accounted for 13.1 hours per physician per week.
  • Very little time was spent submitting quality data in either the United States or Ontario.

The study highlights provisions within the ACA such as, fostering the adoption of bundled payment and accountable care organizations, that could reduce administrative costs in the long term.

Resource Details

Date: Aug 2011
Author: Dante Morra