Quality Care Reality Bites

Quality Care Issues and Costs

No one can argue that improving quality care is a worthy goal.  Interpretation of how it is best done gets bogged down especially when it comes to figuring out what’s required, obtaining and interpreting the  information, translating it into inadequate software templates developed by non-medical techs, then reporting it in a way that is manageable for payers.

As is commonly reported because so many vendors jumped onto the EMR (electronic medical record) bandwagon to develop proprietary software products, the missing ingredient was standardization.  All of those myriad systems now in use by providers cannot talk to each other at all, so much of the effort is wasted, in fact, it has markedly slowed any realistic benefit.

A major part of the effort was to create value-based care, that is, what was the patient seen for, what was done and what was the outcome.  The idea pushed by Medicare with the Reauthorization Act in 2015 was designed to improve the payment process for value-based care, so providers get paid more if they can prove the care was better?

Providers try hard to meet the increasing requirements but how has that affected their practices?  A study was done of 1000 practices representing several specialties; the results showed that the office staff averaged 15.1 hours per week per physician to try to fulfill the new standards.  The costs were calculated at a surprising  $40,000 per physician per year –  a whopping $15.4 billion per year spent on just that part of the new regulatory mandates.  That does not include the time spent in understanding the rules, trying to provide the required information, and then interpret any feedback from payers, not to mention tracking the rule changes.

With the failure of useful EMRs, the quality reporting issues are following the same pattern, confusion rules with no standards, and increasing provider overhead resulting in a colossal waste of time, and ultimately less time spent on patient care (surely an issue with quality?).