Administrative, compliance tasks are choking US healthcare, cardiologist says

The mountain of rules physicians, nurses and hospitals must follow in the U.S. consumes millions of hours and hundreds of billions of dollars annually — and reform is needed, cardiologist Sandeep Jauhar, MD, argues in an essay published in The Wall Street Journal.

There are several stats that reveal how administrative tasks are choking U.S. healthcare, Dr. Jauhar wrote. The average hospital today has about 60 full-time employees to help it adhere to thousands of regulations, and a recent study found that the U.S. spends $265 billion on unnecessary regulatory and administrative tasks in healthcare, he said. This is more than the U.S. spends on cancer or heart disease, Dr. Jauhar wrote. 

Many healthcare rules were published with a good intention. For example, a lot were developed to address excess spending, improve clinical quality and stomp out fraud. But over the years, these regulations have been added to the mountain of rules without being questioned or analyzed to see if they continue to provide a benefit. 

One example is prior authorization. The rule was established to help prevent patients from receiving unnecessary treatments, but it has evolved into a tool insurers use to deny reimbursement to hospitals, Dr. Jauhar wrote.

"Prior authorization for unnecessary care, such as an MRI for a run-of-the-mill headache, has been swamped by prior authorization for standard care," Dr. Jauhar wrote.

Dr. Jauhar is calling for reform and reduction of the regulatory burden on the healthcare industry. Suggested reforms include more flexibility built into regulations, physician involvement in setting regulatory changes and more scrutiny of opportunity costs of compliance intime and money.

"Reducing the burden of counterproductive regulatory complexity could save billions of dollars as well as countless physicians’ careers," Dr. Jauhar wrote. 

Read the full essay here

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