I heard this story yesterday on 'Marketplace' and was stunned. I doubt many people are aware of the extent and the costs involved.
Anyone who is seriously interested in reducing health care costs will check this out. And by the time you are finished with it, you may just be cheering parts of Obama's new healthcare law.
I've included a few snippets, but it is best to just listen to the story:
The battle over billing codes | Marketplace from American Public Media
Kai Ryssdal: There are two main things that happen when you go to the doctor. You get your exam or check-up or treatment for whatever ails you. And there's a bunch of paperwork. Some that you do before you get seen -- histories, allergies -- and some the doctor does afterward. Usually a piece of paper with a bunch of numbers on it. Procedure codes. You probably don't pay much attention to 'em. No reason you should. But they're the very heart of the way we do health care because every one of 'em has a dollar amount attached.
*snip*
And in this game, Larry Rabon has become a grandmaster. He's increased his revenue by 70 percent -- hundreds of thousands of dollars per year.
Rabon: I'm doing the same amount of work.
He's just charging for every little thing he's doing. It's like a code war between doctors and insurance companies. And the hotter this war gets, the more it costs... us. Our premiums and taxes pay for the coding gurus and soldiers on each side. There are now 2.2 people doing billing for every one doctor in America.
Cutler: It's a major part of the health care industry spent just dealing with that back and forth.
That back and forth -- you'd know this if you've ever been caught up in it -- means reams of extra paperwork and referrals and authorizations and denials and appeals and this costs an extra $360 billion a year. That's according to the Institute of Medicine. Which is to say, if we could just shave off one seventh of the extra bureaucracy...
Cutler: That's well more than it would cost to bring insurance coverage to every single American who is now uninsured.
So can we get rid of the codes? Well, some doctors and hospitals are already signing up for a new program under the health care reform law that would pay doctors by a lump sum instead of per procedure. But other doctors don't want to give up their independence. Larry Rabon and his family have gotten used to playing the chess game. And if every doctor played as well as they do, then our deficit would really be in trouble.
In Orlando, Fla., I'm Gregory Warner for Marketplace.
Anyone who is seriously interested in reducing health care costs will check this out. And by the time you are finished with it, you may just be cheering parts of Obama's new healthcare law.
I've included a few snippets, but it is best to just listen to the story:
The battle over billing codes | Marketplace from American Public Media
Kai Ryssdal: There are two main things that happen when you go to the doctor. You get your exam or check-up or treatment for whatever ails you. And there's a bunch of paperwork. Some that you do before you get seen -- histories, allergies -- and some the doctor does afterward. Usually a piece of paper with a bunch of numbers on it. Procedure codes. You probably don't pay much attention to 'em. No reason you should. But they're the very heart of the way we do health care because every one of 'em has a dollar amount attached.
*snip*
And in this game, Larry Rabon has become a grandmaster. He's increased his revenue by 70 percent -- hundreds of thousands of dollars per year.
Rabon: I'm doing the same amount of work.
He's just charging for every little thing he's doing. It's like a code war between doctors and insurance companies. And the hotter this war gets, the more it costs... us. Our premiums and taxes pay for the coding gurus and soldiers on each side. There are now 2.2 people doing billing for every one doctor in America.
Cutler: It's a major part of the health care industry spent just dealing with that back and forth.
That back and forth -- you'd know this if you've ever been caught up in it -- means reams of extra paperwork and referrals and authorizations and denials and appeals and this costs an extra $360 billion a year. That's according to the Institute of Medicine. Which is to say, if we could just shave off one seventh of the extra bureaucracy...
Cutler: That's well more than it would cost to bring insurance coverage to every single American who is now uninsured.
So can we get rid of the codes? Well, some doctors and hospitals are already signing up for a new program under the health care reform law that would pay doctors by a lump sum instead of per procedure. But other doctors don't want to give up their independence. Larry Rabon and his family have gotten used to playing the chess game. And if every doctor played as well as they do, then our deficit would really be in trouble.
In Orlando, Fla., I'm Gregory Warner for Marketplace.
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