The post highlights a study by a team from Massachusetts General Hospital and its physician’s organization. They examined the time and costs associated with the third-party billing system used in the U.S and calculated that they could save billions by just  streamlining  typical administrative inefficiencies.

The analysis, published in Health Affairs and funded by the Commonwealth Fund and the Robert Wood Johnson Foundation, looked at a large, multi-specialty group of doctors that uses the typical fee-for-service model. They looked at what might reduce some of the administrative burden – specifically, the time spent by physicians and office staff doing paperwork and going back and forth with payers.

“Achieving these savings would not require restructuring the basic market-system tenets of our complex health care system through, for example, mandating a single-payer approach,” the researchers write.

Medical billing companies like MAS have been on the front line of streamlining costs since the 1970’s and is a major reason why our industry has taken off since. Over the years. many doctor groups and hospital have taken advantage of our expertise to increase cash flow, including niche billing skills delivered by MAS,  such as Workers’ Compensation and No-Fault or Ambulance / Emergency Transport Billing.

Another trend that MAS has seen is for clients to use our billing company on a project basis, as with our Third-Party Follow-Up and Trial Balance Cash Improvement programs.  Our team literally becomes an extension of the client’s back office, benefiting them by keeping their office focused on the day to day’s most pressing needs.

What also works well is a contingency billing scale in which healthcare organizations take advantage of a sliding pay schedule that adjusts with need and patient volume. This becomes a win-win when hospital and physician organizations protect bottom line costs while still having a trained staff  available when they need them the most.

There is no doubt the battle in streamlining costs in healthcare is a challenging one. When I read a report like this one I get energized and it reminds me that success can be ours!  By working together and relying on the various industry segments to do their part,  MAS believes that our healthcare industry can save billions. The model is there for us to follow. We look forward to doing our part to streamlining costs– one doctor office, one clinic, one doctor group and one hospital at a time.

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My concern is this: how much can we abdicate our responsibility as human beings to take care of ourselves?  Do you really need to be paid everyday to take a medication that prevents you from dropping dead within minutes due to a heart attack, stroke or any other malady one can think of?  I can recall when my son took Singulair to prevent the terrible asthma attacks he would get, often sending him to the hospital.  To me, there was nothing more important than making sure that child had that medicine that kept him healthy!  I created a routine to assure myself that I would never forget his daily dose.

That being said, there is a bigger issue, at least for me, in question here or the next layer, if you will: how has the government gotten so intimately involved in maintaining or treating our health and our bodies?  In the words of the great Ronald Reagan, “Government exists to protect us from each other. Where government has gone beyond its limits is in deciding to protect us from ourselves.” Yes, I know that paying people may prevent hospitalizations, spending a lot of money, etc…but involving the government in personal health compliance seems like a potentially slippery slope.

Another thought I have is, would these same people being paid to essentially take care of themselves be willing to get paid to take poison, that is, if the government offered it at a good payout?  I mean, if it could turn a good profit and one doesn’t care about their health anyway, why not right??

What do you think??

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According to Big Four auditing firm PriceWaterhouseCoopers (PwC) and government estimates, labor costs today account for the largest increase in spending by healthcare providers. PwC determined that paperwork for a typical medical patient adds a full 30-60 minutes to every hour of actual patient care. Given this figure, it comes as no surprise that total labor costs are projected to reach 38% of total healthcare spending. To put this into sharper perspective, compare this percentage to 3% for Pharmaceuticals, 5% for Technology and 1% for Construction.

Despite soaring costs, the Healthcare Financial Management Association (HFMA) reports that healthcare industry experts still recommend a cost-to-collect percentage guideline of between 2-3%. However, many healthcare institutions fail to take into account other contributing cost factors such as human resources, technology and telecommunications, all of which can drive their cost-to-collect well above the 5% mark.

“When you see an organization’s collection numbers, it’s important to know what they put into that,” says Aaron Crane, CFO of Salem Hospital, Salem, OR. “One organization might be collecting a lot but spending a lot to get that, while another might collect less but be getting a better return for what they spend.”

Outsourcing particular business functions is an effective way for a hospital to contain the rising labor costs of getting claims paid. “Outsourcing (has) proven that it does work,” says Scott Johnston, HFMA technical director. “Many hospitals don’t feel confident in the billing field. Why not outsource when someone else can do it better?”

The outsourcing solution does not necessarily mean a hospital must outsource its entire medical billing operation. Particular financial classes within the revenue cycle, such as aged third party receivables, No-Fault / Workers’ Compensation and others, are particularly appropriate candidates for outsourcing.

Care should be taken in choosing an outsource medical billing services provider. The provider should have a reputation for timely, ethical and professional services, a high collections ratio, innovative techniques, secure electronic communications systems, highly-trained staff, hands-on management, and the flexibility to custom-tailor programs and services to meet the institution’s unique business requirements.

With a two-decade track record of delivering superior medical billing outsource services to the healthcare industry, Medical Account Solutions (MAS) qualifies as that caliber of provider.

About Medical Account Solutions

Since 1986, Medical Account Solutions (MAS) has dedicated itself to developing and delivering Healthcare Accounts Receivable Programs that increase and streamline healthcare institutions’ cash collections without spending their resources.

Customized Revenue Management

By applying its Customized Revenue Management Services – including Flexible Proprietary Software, Certified Billing Professionals and Seamless Systems Integration – MAS becomes the hospital’s “other business office”. The end result – faster, more efficient, timely and thorough collections – saves dollars and time without jeopardizing the institution’s financial integrity, business office processes or public relations. To optimize cash flow, MAS customizes its Accounts Receivable Programs – including Day-One Billing, Aged Receivable Follow-Up,

Accounts Receivable Outsourcing and Ad Hoc Programs – to fit each client institution’s exact needs, however unique they may be.

Flexible Proprietary Software

MAS’ proprietary applications cover all services, including paper and electronic claim production, automated remittance processing, month-end reporting, inbound and outbound interface processing, and other functions. The MAS system utilizes add-in functionality for claim quality assurance, insurance verification and authorization and insurance searches. A special module performs follow-up activities based on account age and other factors set up by MAS with the client.

Certified Billing Professionals and Ongoing Training

Ongoing MAS staff training is provided through several professional organizations, including AHEM, HFMA and Ingenix, Inc., as well as online training websites such as MedLearn.com. Each staff member is required to attend, either in person or online, several seminars each year covering all new HIPAA and billing regulations for all payors.

Seamless Systems Integration

MAS specializes in integrating its flexible proprietary software with the leading vendors’ healthcare patient accounting software and can download virtually any file type through its File Transfer Protocol (FTP) server. Remote communications are established as secure, bi-directional VPNs with encryption, allowing communications between the MAS network and the client’s systems. The open, flexible and scalable architecture built into all MAS proprietary software affords the flexibility to seamlessly and efficiently accommodate the client’s existing billing and operating systems.

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