Administrative Costs Associated With Physician Billing and Insurance-Related Activities at an Academic Health Care System

Tseng, P.; Kaplan, Robert S.; Richman, Barak D.; Shah, Mona; Schulman, Kevin A.

doi:10.1001/jama.2017.19148

Cited by 115 publications

(149 citation statements)

References 31 publications

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“…Therefore, if well-constructed, this method can be used to optimize the care cycle [41,34], resulting in cost-saving outcomes [25]. If authors apply their TDABC strategies with higher methodological rigor, the results from parallel studies can be compared and replicated, opening new avenues to redesign initiatives to optimize care cycles in different healthcare settings [43].…”

Section: Discussionmentioning

confidence: 99%

A standardized framework to evaluate the quality of studies using TDABC in healthcare: The TDABC in Healthcare Consortium Consensus Statement

Etges

Polanczyk

Urman

2020

Preprint

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Background: This Consensus Statement introduces a standardized framework, in a checklist format, to support future development and report of TDABC studies in healthcare, and to encourage their reproducibility. Additionally, it establishes the first formal networking of TDABC researchers through the creation of the TDABC for Health Care Consortium.Methods: A consensus group of researchers reviewed the most relevant TDABC studies available in Medline and Scopus databases to identify the initial elements of the checklist. Using a Focus Group process, each element received a recommendation regarding where in the scientific article section it should be placed and whether the element was required or suggested. A questionnaire was circulated with expert researchers in the field to provide additional recommendations regarding the content of the checklist and the strength of recommendation for each included element. Results: The TDABC standardized framework includes 32 elements, provides recommendations where in the scientific article to include each element, and the strength of each recommendation. All 32 elements were validated, with 21 elements classified as mandatory and 11 as suggested but not mandatory. Conclusions: This is the first standardized framework to support the development and reporting of TDABC research in healthcare and to stablish a community of experts in TDABC methodology. We expect that it can contribute to scale strategies that would result in cost-savings outcomes and in value-oriented strategies that can be adopted in healthcare systems and institutions.

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Section: Discussionmentioning

confidence: 99%

A standardized framework to evaluate the quality of studies using TDABC in healthcare: The TDABC in Healthcare Consortium Consensus Statement

Etges

Polanczyk

Urman

2020

Preprint

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“…[69] Billing costs could make up 3% to 25% of physician professional revenue per patient encounter. [70] The data suggests that there is still much room for improving billing processes. The healthcare system appears to lag behind other industries in areas of billing transparency, customer self-service, and electronic and mobile billing.…”

Section: Health-social Integrationmentioning

confidence: 99%

Finance transformation for healthcare: A structured model for planning and action

Tan¹,

Juan²

2019

IJH

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With rising healthcare costs, payers are transforming the way they pay healthcare providers. Currently, there is much interest in value-based financing and accountable care models. However, finance transformation in healthcare goes beyond changing funding models. The way funds flow to providers and how patients share healthcare costs also need to be transformed to ensure an overall sustainable value-based financing system. A structured model of finance transformation in healthcare is proposed in this article supported by evidential review, which discusses several fundamental and critical factors affecting finance transformation and explores some strategies that could help sustain the new financing models. Hopefully, this model can serve as a useful guide to healthcare systems embarking on finance transformation for long term cost sustainability.

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“…O mapeamento das atividades descreveu todos os recursos, bem como o consumo de suprimentos usados ao longo do fluxo de cuidado do paciente (Martin et al, 2018). De acordo com as orientações da literatura, o mapeamento foi realizado por meio de entrevistas com os profissionais envolvidosmédicos, enfermeiros, gerentes e analistas financeiros -, bem como observações in loco para cada etapa do processo (Tseng et al, 2018). A inclusão da equipe multiprofissional garantiu que os protocolos existentes no departamento fossem contemplados no mapeamento, além de fornecer maior credibilidade ao resultado final (Keel et al, 2017;McBain et al, 2016).…”

Section: Coleta De Dadosunclassified

“…Empresas prestadoras de serviços de saúde estão buscando soluções capazes de prover informações em métodos de custeio a fim de agregar melhorias no processo e orientação ao VBHC. Elas são motivadas pela dificuldade de entendimento das informações financeiras e seu impacto na administração e avaliação do desempenho financeiro dos serviços (Tseng et al, 2018;McBain et al, 2016). Dentre os métodos de custeio recomendados para a análise dos serviços de saúde, destaca-se o método de custeio baseado em atividades e tempo (Time-Driven Activity-Based Costing -TDABC) (Keel et al, 2017).…”

Section: Introductionunclassified

Custeio Baseado em Atividade e Tempo (TDABC) em um departamento de radiologia hospitalar no sul do Brasil

Daroit¹,

Ruschel²,

Tarrago³

et al. 2018

JBES

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Objetivo: Mensurar o custo dos serviços do departamento de radiologia de um hospital privado no sul do Brasil e avaliar o desempenho financeiro do setor quando comparado ao repasse da tabela aos hospitais do Sistema Único de Saúde (SUS). Métodos: Estudo de caso baseado na metodologia Custeio Baseado em Atividade e Tempo (TDABC). Após a definição dos exames de maior incidência, houve a análise do processo de realização de exames de radiografia de tórax, ecografia de abdômen total, tomografia de crânio, tomografia de tórax, ecografia pélvica transvaginal, ecografia de aparelho urinário e ressonância magnética de crânio. Foram coletados os tempos das atividades para a realização de cada exame, informações dos custos do departamento, bem como as definições das capacidades dos serviços para calcular o custo dos exames em função das atividades e tempo. Resultados: Pode-se inferir que, na comparação com os valores de repasse do SUS, todos os exames analisados apresentaram custos superiores ao repasse. Além disso, observou-se que cerca de 80% dos custos estão relacionados ao custo fixo da estrutura do departamento de radiologia e 12%, ao profissional médico. Conclusão: O TDABC demonstrou ser um método oportuno para análise de custeio em um departamento de radiologia hospitalar. Por meio dos resultados apresentados, pode-se propor melhorias a fim de reduzir custos para um maior desempenho do serviço.

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Administrative Costs Associated With Physician Billing and Insurance-Related Activities at an Academic Health Care System

Cited by 115 publications

References 31 publications

A standardized framework to evaluate the quality of studies using TDABC in healthcare: The TDABC in Healthcare Consortium Consensus Statement

A standardized framework to evaluate the quality of studies using TDABC in healthcare: The TDABC in Healthcare Consortium Consensus Statement

Finance transformation for healthcare: A structured model for planning and action

Custeio Baseado em Atividade e Tempo (TDABC) em um departamento de radiologia hospitalar no sul do Brasil

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