Managing the Cost of Measuring Care

Dr. Jon Handler
Dr. Jon Handler

Guest post by Jonathan A. Handler, MD, FACEP and chief medical information officer for M*Modal.

The U.S. Government officially recognizes that filling out paperwork is expensive. The most costly paperwork requires us to measure and report information – like our yearly income. If you have ever filled out a government form, you may have noticed that it provides an estimated cost to complete.

For example, the simplest “EZ” income tax form will cost each taxpayer an average of four hours and $40 ( — page 41). This is a result of the Paperwork Reduction Act, which requires the government to reduce the paperwork burden on the public and publish the estimated cost of completing each form. However, the Paperwork Reduction Act may have a loophole, because it seems to be limited to government documents.

The government creates a tremendous documentation burden on healthcare providers that appears to fall outside the scope of the Act. In 2014, new government requirements will increase that workload dramatically even as reimbursement drops. Since we do not have consensus on how to address these changes without sacrificing patient care, I believe a key trend in 2014 will be “Managing the Cost of Measuring Care.”

Clinicians are already at the breaking point in the time they spend on documentation and care measurement. This year, regulations demand more than ever. The move to ICD-10 significantly increases the cost of choosing the right billing code because ICD-10 is more complex and about eight times bigger than ICD-9. Stage 2 of the government’s meaningful use program requires clinicians to record more patient information in structured form, to report clinical quality measures, to perform medication reconciliation, and much more. The Two-Midnight rule requires physicians to anticipate when an admitted patient will need to stay in the hospital longer than “two midnights” and justify that in writing.

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