Researchers say EHR adoption doesn't cut hospital billing costs: 5 study findings

In a large academic health system using an EHR, billing and insurance costs can range from $20 for a primary care visit to $215 for inpatient surgical care, according to a study published in JAMA.

For the analysis, researchers from Durham, N.C.-based Duke University School of Medicine and Boston-based Harvard Business School examined and estimated administrative price tags for five billing activities within an EHR-enabled academic health system.

Here are five findings from the study.

1. The study considered time-driven activity-based costing. In 2016 and 2017, researchers conducted interviews with 27 administrators and 34 physicians at the unidentified health system. Researchers followed insurance claims through the revenue cycle management process and used data to determine the cost of certain billing activities.

2. Researchers estimated billing and insurance-related costs for primary care visits, discharged emergency department visits, general medicine inpatient stays, ambulatory surgical procedures and inpatient surgical procedures.

3. The study authors estimated the following times and costs per patient encounter for the EHR-enabled academic health system:

  • Primary care visit: 13 minutes and $20.49
  • Discharged ED visit: 32 minutes and $61.54
  • General inpatient stay: 73 minutes and $124.26
  • Ambulatory surgical procedure: 75 minutes and $170.40
  • Inpatient surgical procedure: 100 minutes and $215.10

4. Based on the study, researchers estimated billing costs for primary care visits cost the system $100,000 per provider each year, The Harvard Gazette reports.

5. Study author Kevin Schulman, MD, of the Duke Clinical Research Institute, the Duke University School of Medicine and Harvard Business School, told The Harvard Gazette, "We found no evidence that adoption of these expensive electronic health record systems reduced billing costs related to physician services." Rather, the researchers determined administrative costs found in the study largely reflected varied payment requirements across multiple payers contracting with the academic health system.

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