A solution for America’s uninsured always seems financially unsustainable. Sure, other countries have it, but they don’t have 300 million people, vast disparities in household incomes and general wealth, a third-world country next-door neighbor with a broken fence latch, and a military.
Well, thanks to the embarassing inefficiencies present in our current health care system, the solution to most of its problems lies in wringing a bit of extra water out of an absolutely saturated sponge. The difficulty doesn’t lie in the amount of water in the sponge, it’s getting a proper grip…which is particularly tricky. Enough with the ill-conceived metaphors.
Cheryl Hall‘s business column in the Dallas Morning News discusses MedSynergies, a company capitalizing on the collection side of medicine. J. R. Thomas, the CEO of the company, cites a McKinsey & Co. study that has found what could be the single biggest problem with American health care – the billing and collections process. The study finds that 15-20% of the cost of health care goes towards billing and collections – that’s $350 billion per year as bills needlessly bounce between patients, doctors, hospitals, and insurers. This would be enough to cover 40 million uninsured Americans. Most businesses cannot survive with a 20% cost of collections. Perhaps businesses with significant barriers to entry, like bounty hunting…
Here’s some stupefying excerpts: for every 100 bills a typical private-practice doctor sends to insurance companies, 30 are kicked back because the forms were filled out wrong, the procedures weren’t covered or the rules were so incomprehensible that the doctor’s office couldn’t follow them. Emergency room bills often have a 40-plus percent initial rejection rate. MedSynergies is able to reduce this to 10% and 20%, respectively. Typically, a medical provider has to send out bills – to the patient, the government or the insurance company – four times to get fully paid, Thomas says. But it often takes six or seven bills, and it’s not uncommon for it to take a dozen attempts to “zero out” the balance.
So, is the only solution to this problem for hospitals and private-practice physicians to hire MedSynergies? Well no, there’s a much simpler solution. It involves changing the way providers do business. With the advent of Health Savings Accounts, there’s a growing population of people who are paying cash for much of their medical expenses. The problem is, there is no transparent pricing for patients to use as a benchmark. That’s all changing. Doctorpricing.com is a physician cash network that is slowly filling in the missing pieces by creating a true market for health care. Thousands of doctors are tired of the expenses associated with the billing process, and the time value of money issues of having accounts receivable for 3-6 months in some cases. Doctors who create a profile on Doctorpricing.com can offer point-of-service, cash pricing for consultations and medical procedures — eliminating much of their overhead.
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