Administrative Waste in U.S. Healthcare
Regardless of technological advancement, life-saving skills and abilities and first-world resources, the outlandish cost of healthcare in the United States far surpasses any other country in the world. From price gouging, to double billing, to overbilling, to inefficient and expensive operations, the United States wastes $750 billion every year through our healthcare system. According to the Institute of Medicine (IOM), $200 billion of that astronomical number is due to nothing more than administrative waste. It is estimated that 15 cents of every dollar spent on healthcare is wasted due to inefficient administrative practices.
Even though the majority of the negative focus largely surrounds the shortcomings
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Since the quality of healthcare would not suffer, the only thing to lose through maximizing efficiency is a bunch of waste. Through its administrative simplification advocacy, the American Medical Association (AMA) claims that up to 14% of a physician’s revenue is taken up by administrative waste. The goal of the administrative simplification is to inspire physician practices to use computerized, instantaneous health plan transactions, minimize manual procedures through the claims revenue cycle, while increasing transparency and reducing vagueness with the payment process involving the insurance company. It is the AMA’s hope to push this movement into high gear, getting more practices on board and to eventually see a decline in wasteful and inefficient administrative …show more content…
As you can see by the overlap in percentages, some physicians use both methods to request authorizations. The AMA also says that an electronic system of pre-authorization would save an estimated $1,700 every year per physician. Maybe the savings doesn’t seem all that impressive when looking at it from a per-physician standpoint; however, if that electronic system became the norm and was adopted by every single physician in the United States, the savings would be
The government controls and regulates healthcare somewhat because healthcare organizations are in a position to take advantage of the elderly and sick so there are regulations that protects them. It seems as though healthcare facilities are being paid less for their services today. Some critical measures for the survival of a healthcare organization are to optimize performance and quality. Finding system-wide efficiencies and cost reduction healthcare will help. In order to get better and keep high quality and performance while still raising reimbursements, it is necessary and important to involve doctors with the ideas and plans for any management strategies.
During the study of various reforms that were proposed and denied, both the GOP and Democrats attempted to find a balance that would guarantee the success of their proposals. Years of research, growing ideologies, political views and disregard for the country's constitution sparked an array of alternatives to solve the country's healthcare spending. The expenditure of US healthcare dollars was mostly due to hospital reimbursements, which constitute to 30% (Longest & Darr, 2008). During the research for alternatives, the gr...
For the last five years of my life I have worked in the healthcare industry. One of the biggest issues plaguing our nation today has been the ever rising cost of health care. If we don't get costs under control, we risk losing the entire system, as well as potentially crippling our economy. For the sake of our future, we must find a way to lower the cost of health care in this nation.
The amount of money that is spent on healthcare is a quite a bit of money but about 10% of all the money is a result of some sort of medical fraud or abuse. This is about 120 billion dollars. With HIPAA (Health Insurance Portability and Accountability Act) medical fraud and abuse can be tracked easier. HIPAA was enacted in august of 1996; this was to help improve the portability and continuity of the health insurance.
In order to fully understand the uninsured and underinsured problem that hospital administrators face the cause must be examined. The health outcomes of uninsured individuals are generally worse than those who are insured. Uninsured persons are more likely to experience avoidable hospitalizations, diagnosed at later stages of disease, hospitalized on an emergency or urgent basis, and more seriously ill upon hospitalization (Simpson, 2002) Because the uninsured often lack an ongoing relationship with a health-care provider, they are less likely to receive preventive care and diagnostic tests (Kemper, 2002). Many corporations balance their budget through cost cuts and other moves, but have been slammed with an increasing load of uninsured patients, coupled with reduced payments from government and private insurance programs. In 2000, 564,476 uninsured patients came through Health and Hospitals Corporations health care centers, a 30 percent increase from 1996. In the same period, Congress reduced Medicare reimbursements to hospitals, while Medicaid reimbursements to primary care clinics remained basicall...
In order to make ones’ health care coverage more affordable, the nation needs to address the continually increasing medical care costs. Approximately more than one-sixth of the United States economy is devoted to health care spending, such as: soaring prices for medical services, costly prescription drugs, newly advanced medical technology, and even unhealthy lifestyles. Our system is spending approximately $2.7 trillion annually on health care. According to experts, it is estimated that approximately 20%-30% of that spending (approx. $800 billion a year) appears to go towards wasteful, redundant, or even inefficient care.
As I began watching Reinventing Healthcare-A Fred Friendly Seminar (2008), I thought to myself, “man, things have changed since 2008.” And as the discussion progressed, I started to become irritated by how little had changed. The issues discussed were far-reaching, and the necessity for urgent change was a repeated theme. And yet, eight years later, health care has made changes, but many of its crucial problems still exist.
Despite the established health care facilities in the United States, most citizens do not have access to proper medical care. We must appreciate from the very onset that a healthy and strong nation must have a proper health care system. Such a health system should be available and affordable to all. The cost of health services is high. In fact, the ...
The U.S. expends far more on healthcare than any other country in the world, yet we get fewer benefits, less than ideal health outcomes, and a lot of dissatisfaction manifested by unequal access, the significant numbers of uninsured and underinsured Americans, uneven quality, and unconstrained wastes. The financing of healthcare is also complicated, as there is no single payer system and payment schemes vary across payors and providers.
The United States health care system is one of the most expensive systems in the world yet it is known as being unorganized and chaotic in comparison to other countries (Barton, 2010). This factor is attributed to numerous characteristics that define what the U.S. system is comprised of. Two of the major indications are imperfect market conditions and the demand for new technology (Barton, 2010). The health care system has been described as a free market in
A very notable goal is to make healthcare affordable for all Americans and at the same, improving the quality and efficiency in which healthcare is conducted. Many look at this act and notice the key benefits that are provided for all Americans, and are interested to find other improvements that help everyday ...
Rising medical costs are a worldwide problem, but nowhere are they higher than in the U.S. Although Americans with good health insurance coverage may get the best medical treatment in the world, the health of the average American, as measured by life expectancy and infant mortality, is below the average of other major industrial countries. Inefficiency, fraud and the expense of malpractice suits are often blamed for high U.S. costs, but the major reason is overinvestment in technology and personnel.
Reforming the health care delivery system to progress the quality and value of care is indispensable to addressing the ever-increasing costs, poor quality, and increasing numbers of Americans without health insurance coverage. What is more, reforms should improve access to the right care at the right time in the right setting. They should keep people healthy and prevent common, preventable impediments of illnesses to the greatest extent possible. Thoughtfully assembled reforms would support greater access to health-improving care, in contrast to the current system, which encourages more tests, procedures, and treatments that are either
Healthcare administration provides leadership and managemnt to health care systems, hospitals, and private or public health systems. There are requirements for most professions in the health industry but with the proper education and certification, most entry-level careers are attainable. Healthcare administrators are leaders so one must be able to handle the responsibility of the job. There are characteristics that can be associated with being a health care administrator. I have learned over the course of the past few weeks that this the career path that I would like to follow and have set a few goals to help promote my career growth. My research has helped me learn many aspects of this profession and what it takes
I heard a conversation at a seminar that was held by the Austin Forum. At that time, one of the officials in the Dell Medical School, Maninder Kahlon, PhD, was explaining the following example. One of the cancer drugs came in one-size-fits-all vials, so the whole body of the cancer patient, whether big or small, will get the same drug. The doctors can adjust the dosage, sometimes used one-third or one-fourth of these drugs and discarding the rest. This continues to happen every year and the waste is expected to reach a value of $1 billion dollars a year, but nobody is doing anything about it. The doctors weren’t concerned enough about the drugs. The patients never knew whether the drugs that they purchased were discarded. Even if they knew, they would not really care because their bills are paid by an insurance company and the government. The distributor, they never got complains and continues to receive a large profit. The result of all this is the increase of budget expenditures in health care. Surprisingly, the government initially saw this favorable because it has administered a good health to its citizens. However the facts said the opposite, according to data, American people are not getting healthier. This waste of money leads to inefficiency. This is where the health care reforms need to be renewed. We cannot fix only one side of the problem because it will not satisfy all parties. The