1Center or American Progress | Replace Fee-or-Service with Bundled Payments in Medicare
Cut Administrative Costsin the Health System
David M. Cutler, Ezekiel J. Emanuel, and Topher Spiro October 2011
Te Institute o Medicine estimates that the United States spends nearly $360 billionannually on administrative costs.
1
As much as hal o that is unnecessary and excessive.Estimates suggest that administrative simplication could reduce the systemwide costso health care administration by about $40 billion per year.
2
Payers and providers agree that the system is broken. And they even agree on many o the operations needed to achieve administrative simplication. Some o these steps werecodied in the Aordable Care Act, such as the development o standard operating rulesor the electronic processing and billing o many common medical services. Signicantadministrative savings can be achieved by ensuring eective implementation o the ACA. But there is more to be done.
Recommendations
Require electronic integration of administrative functions such as billing, priorauthorization, and payments.
Te HIECH Act, part o the American Recovery andReinvestment Act, invested in health inormation technology that is put to meaning-ul use. Te act currently ocuses on the electronic exchange o
clinical
inormation;to achieve administrative efciencies,
administrative
inormation must be exchangedelectronically, too. Electronically integrating clinical and administrative unctions—so that the recording o clinical services ordered or a patient automatically bills theinsurer, or example—should be required as one o the criteria or meaningul use o electronic health record technology.
Require providers to transmit and receive eligibility, claims, and other administrativeinformation electronically as soon as the relevant operating rules are specified.
Asrequired by the ACA, development o operating rules on eligibility, claims, and otheradministrative inormation is already underway. Medicare plans to require electronic
Search History:
Result 00 of 00
00 results for result for
p.
Cut Administrative Costs in the Health System
David M. Cutler, Ezekiel J. Emanuel, and Topher Spiro explain how to achieve significant administrative savings in the health system.
615
Reads
1
Readcasts
1
Embed Views
More From This User
Notes
Load more
