Health Affairs

Health Affairs, doi: 10.1377/hlthaff.28.4.w533 (Published online May 14, 2009) © 2009 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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What Does It Cost Physician Practices To Interact With Health Insurance Plans?

Lawrence P. Casalino ^1*, Sean Nicholson ², David N. Gans ³, Terry Hammons ⁴, Dante Morra ⁵, Theodore Karrison ⁶, Wendy Levinson ⁷

¹ Larry Casalino is chief of the Division of Outcomes and Effectiveness Research, Weill Cornell Medical College, in New York City.
² Sean Nicholson is an associate professor in the Department of Policy Analysis and Management at Cornell in Ithaca, New York.
³ David Gans is vice president, Practice Management Resources, at the Medical Group Management Association (MGMA) in Englewood, Colorado.
⁴ Terry Hammons is a senior fellow at the Medical Group Management Association (MGMA) in Englewood, Colorado.
⁵ Dante Morra is an internist and Clinical Teaching Unit director at Toronto General Hospital, University of Toronto (Ontario).
⁶ Theodore Karrison is a research associate professor in the Department of Health Studies, University of Chicago (Illinois).
⁷ Wendy Levinson is the chair of the Department of Medicine, University of Toronto.

^*Corresponding author.

Abstract

Physicians have long expressed dissatisfaction with the time they and their staffs spend interacting with health plans. However, little information exists about the extent of these interactions. We conducted a national survey on this subject of physicians and practice administrators. Physicians reported spending three hours weekly interacting with plans; nursing and clerical staff spent much larger amounts of time. When time is converted to dollars, we estimate that the national time cost to practices of interactions with plans is at least $23 billion to $31 billion each year. Health Affairs 28, no. 4 (2009): w533-w543 (published online 14 May 2009; 10.1377/hlthaff.28.4.w533)]

Key Words: Business Of Health, Consumer Issues, Physicians, Health Spending

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