Hospitals struggling with reining in costs need to realize that a huge chunk of their expenses are controlled by physicians. The trouble is that doctors haven’t received enough training to properly manage this huge fiscal responsibility and reduce billing errors, reveals a new study in the Journal of the American Medical Association.
Some estimates say physicians determine or influence at least 60% of healthcare costs. Despite the enormous resources at stake, physicians need more training to reduce billing and coding errors. The overall error rate in the Medicare fee-for-service (FFS) program was 8.6% in 2011, amounting to almost $30 billion. For inpatient hospitals, the error rate was 7.9%. This is according to the Centers for Medicare & Medicaid Services (CMS) Comprehensive Error Rate Testing (CERT) program, which measures improper payments.
What to do: The authors of the study call for state-required continuing medical education in program integrity as a condition for licensure. This is fine, but in the short term, hospitals need to initiate educational efforts pronto to stem the tide of billing errors.