Insurance Reimbursement Nightmare

Doctors will have less and less time to see their patients, as the medical crisis continues to dismantle primary care. The problem lies in insurance reimbursements: doctors’ offices get paid by insurance companies, and insurance companies pay for volume of visits, not for time spent with patients. So offices pack as many patients as they can into one day, and doctors are left with an average of six to eight per patient. That’s not nearly enough time to cover all the things that could be wrong with the patient, both obvious and not-so-obvious.

They also don’t get paid for talking to patients, they get paid for ordering things — tests, procedures, etc. But a test is not worth anything if the doctor does not have the time to talk to the patient and figure out what’s wrong.

Accompanying the unforgiving payment scheme is the immense burden of paperwork. The American Medical Association lists that, year after year, administrative costs rise 50 percent, because so much time must be spent figuring out and filling out piles of paperwork.

And a new obstacle has been erected in the way of proper patient care: insurance companies now require prior authorizations on everything — from medications to CAT scans — which involves even more useless paperwork.

The result? Not only do doctors have less time to see patients, but with whatever time they do have, they might think twice about ordering a test.

The burden of paperwork and the necessity of keeping offices fully packed in order to stay afloat is causing the primary care practice to die a slow and painful death. The Medicare Economic Index predicts that between 2000 and 2015, primary care will see an 81 percent drop in revenue. The family doctor might not be around much longer if this emergency situation isn’t addressed immediately.

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