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The Relationship Between Quality Reporting and Bloated Administrative Costs

Posted by Sue Ellen McKelvey on May 18, 2017

shutterstock_597530036.jpgAn ongoing shift to value-based care in today's healthcare industry offers a great many important benefits to healthcare consumers, healthcare providers, payers and other stakeholders, but the transition has had its share of difficulties as well. Increasing administrative burdens for healthcare providers is one of them. A 2016 study, published in Health Affairs spoke to the impact of this type of reporting requirements on medical practices.

The study looked at data from 1,000 medical practices, assessing costs associated with quality reporting across four common specialties: primary care, cardiology, orthopedic and multi-specialties. Overall, the results showed that the requirements of reporting of quality measures to Medicare, Medicaid, and private payers cost medical practices on average $15.4 billion per year; 785.2 hours per physician annually is spent in working to create these reports.

Some breakdown of overall results: Individual practices reported spending 15.1 hours per physician per week on tasks related to quality measures reporting, with 2.6 hours of that time spent by physicians themselves collating and forming report areas and the remaining 12.5 hours was divided among nurses, medical assistants and other staff.

Those total hours were spent on tasks from entering data into medical records solely for the purpose of quality reporting, reviewing quality reports from others /external sources, tracking quality measure specifications as to requirements, developing and implementing new methods of data collection and related processes and before finally transmitting the reports; checking data sent. The average per-physician costs associated with the new quality reporting areas were said to be at least $40,069 each year.

According to study authors, in the 80 percent of medical practices included in this study, a significant increase in such costs has occurred over the past three years. The long term potential benefits of value based reporting to determine new payment models to save the healthcare system dollars is clear, but there is currently a significant burden being felt by 80% of medical practices. They also state that much of the costs – in terms of physician time and staff duties – are unnecessary, inflated by what is still an inefficient reporting system. It is suggested that a greater effort to standardize some measures, making it easier to report would bring costs under control. If the reporting became a more predictable process, time and angst would be saved.

While requests for changes to the reporting system are made from many areas of a time poor healthcare professionals, until reporting reform actually happens, medical practices have no choice but to deal with the system as it is. Dealing with all its inconsistencies, changes and extraordinary complexities has given it a reputation of bloated administrative costs for those who must abide by these rules. Fortunately, today's healthcare information technology developers are fast responding to these challenges, offering solutions that can help contain or reduce that bloat! A more efficient patient management and clinical records software that can collect data real time whilst you are attending to your processes rather than having to go back at another time to find the data points you are to report.

A solid, modern IT system that includes an advanced patient management software can automate many of the tasks associated with quality reporting. Streamlining quality reporting management via the automation capabilities can reduce the staff-hours, reducing the financial and mental impact of complex quality reporting rules; reducing overall administrative costs. An advanced patient management software built for the healthcare 2020 vision of costs, time and satisfaction measures of the value based reporting payment model can give physicians back the quality time to be with their patients, increasing revenue and patient satisfaction.

As the authors of this study emphasize it is the 2.6 hours per week that the average physician spends dealing with quality measures and reporting requirements that are actually enough time to care for approximately 9 additional patients. The result? Happier Clients, Happier Clinicians and Happier Clinic team - when not stressed out by reporting rules.

So the bottom line is this: If you are still relying on a legacy practice management software solution, designed for yesterday's healthcare system, you're selling your practice short. The demands of today's evolving healthcare landscape are different and more difficult to navigate, and old-school software and spreadsheets just won't do. In other words, it is time to step up to a modern, end to end, fully integrated healthcare IT platform that collects data and values it as the engine beneath that provides solutions for today's healthcare system's demands; doing so is essential to your health AND success in this rapidly developing healthcare environment.

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Topics: Patient Management Software

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