By: Dexter Braff
Brought to you by the letters W, T, and, well, you know. Earlier in the year, the Journal of the American Medical Association released a study on gains/savings made in administrative efficiency and medical billing costs as a result of implementing electronic health records.
And what they found was that the Before and After pictures of EHR implementation looked nothing like what you would see in a NutriSystem Ad. In fact, the report concludes that,
“EHR adoption failed to live up to its promise of lowering administrative costs by processing medical bills under one system” as “Medical billing costs still accounted for up to one-quarter of professional revenue even after certified EHR adoption.”
It goes on to say that,
“Medical billing costs may be just as high or higher [emphasis added] after EHR adoption.”
And this study doesn’t even include the emerging practice of physicians hiring medical transcribers to do battle with the checkbox Kraken that lurks in so many caregivers’ iPads, smartphones, and laptops.
So. After the experts proclaimed EHRs as the savior of the health care system, millions of dollars – and hours – were invested in them, and countless billing personnel had to fill prescriptions for Xanax, we’ve got nothing to show for it?
Not so fast.
First, while the study was conducted by the Duke Medical Center and Haaaaavard B-School, it was limited to Duke’s facilities.
A bit short of statistical significance.
Second, one of the researchers opined that “EHRs were not to blame…because the academic medical center in the study already achieved significant economies of scale by streamlining all of its medical billing functions within a single system.”
In other words, Duke’s baseline costs were already better than most, so there was less room for EHR implementation to wring out further efficiencies?
Maybe, kinda, sorta. But an argument that might fall short in debate club.
Far more compelling is the observation that the tepid performance of EHRs can be tied to
“contract variations between hospitals and payers, as well as varying rules and pricing structures by payer(s). Certified EHR systems have been unable to effectively integrate and manage the complexity of payer contracts.
To a large degree, the significant administrative costs measured in this study are the consequences of heterogeneous payment requirements across the multiple payers and health plans contracting with the academic health center.”
Nailed it.
Who knew health care was so complicated?