Spending Waste in Health Care Administration

The nurse’s questions probed into the granular details of Schulman’s family history of disease. IT made him wonder: Would the answers really help provide improved outcomes for his daughter’s ear infection? Or would they sit idly in some digital purgatory? How much time and money was really being allocated to the point-by-point completion of this electronic form, and who stood to benefit?

Schulman’s frustration from that exam—a simple doctor’s visit turned into a parlor game of questions at the behest of some insurer, probably a thousand miles away—drove him to seek answers. He already knew why health systems followed procedures to comply with billing and insurance requirements. And he knew these practices were a major time-suck for everyone involved. But exactly how bad was it?

In a study published last month, Schulman and colleagues from Duke and Harvard Business School reported that the costs to complete billing and insurance-related activities through an electronic health record (EHR) at an academic health care system could range anywhere from $20 to $215 per visit or procedure. The time allocated to these activities also varies widely, from 13 minutes at the low end, up to about 2 hours.

“These are non-valuated costs, and the patients are paying for it,” Schulman told MD Magazine. “Nobody understands it—this just happens. This isn’t even dealing with the costs of coverage.”

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