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Plan Interactions Cost Doctors

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U.S. physicians, their employees, and their lawyers and accountants may spend an average of about $68,000 in time per physician per year on interacting with health plans.

Researchers have published that estimate in an article in the Web edition of Health Affairs, a health finance journal.

The researchers based their figures on a survey of about 900 physicians and medical group administrators in ordinary solo and group practices. The researchers excluded physicians employed by academic medical centers or health maintenance organizations and some other physicians with unusual practices, such as practices with an unusually large percentage of self-pay patients.

The physicians who participated in the survey reported spending an average of 3 weeks per year interacting with plans. Nurses working with the physicians are spending about 23 weeks per year talking to plans, and clerical staffers spend about 44 weeks per year on plan communications, the researchers estimate.

The $31 billion spent on health plan interactions accounts for about 6.9% of U.S. expenditures on physicians and clinical services, the researchers report.

The researchers note that the time spent on health plan interactions may not necessarily be wasted time. Some of the health plan interactions may produce benefits, by, for example, reducing health care costs or increasing the quality of care, the researchers write.

But researchers should be looking for ways that health plans can make physician practice interactions more efficient, the researchers write.