An insured patient checking out form the physician’s office paid $100 for just 10 minutes with the doctor.  What exactly this $100 covers? Why patients get shocked seeing this type of bill? Here is what that $100 is covering…

• First, doctor office schedules an appointment. It took several people to take the message, pull the medical record (paper charts), call the patient to assess the problem, determine the need for the appointment and schedule it.
• When the patient arrives, staff double checks the patient’s contact info and insurance details to make sure that it is updated on the file.  The nurse gets notification of the patient’s arrival.
• The nurse called the patient from the waiting area, measures blood pressure and weight.  And then patient goes into the exam room where nurse again takes vitals, make notes around the visit reason, medication, last visit, etc.
• The physician came in to see the patient, asked about any changes since last been seen, reviews history of present illness and examines the patient. He talks about the illness and the treatment plan and prescribed a medication. He updates patient’s medication list and makes a copy of the diagnosis form and hand it out to the patient for the records.  The patient goes to the check out desk.
• The physician refiled the medication reconciliation in the chart, finished documenting the visit, and placed the chart in the bin to be refiled.  The chart was filed, and the encounter form was sent to the billing office.
• At the billing office the charges and any payment gets posted and the claim was filed.  If there is no problem with the claim, it electronically gets processed.
• If payment was not denied, the payment arrives at the billing office and would be posted.
• If patient did not pay at the check-out desk, the patient-responsible balance is billed to the patient.  If the patient pays on the first statement, it has taken 45 to 60 days to receive complete payment.

The 10 minute office visit involved the work of the phone operator, the medical records clerk, the triage nurse, the check-in person, the nurse, the doctor, the check-out person and the biller.  It took 8 people, and at least 45 minutes of work to make that appointment happen.  In addition, that visit paid the expenses for the rent, the utilities, malpractice insurance, medical supplies, computers, phones and janitorial services.  We all want efficient and quality health care but it is not cheap.

Thanks to KevinMd for giving this useful insight.

Hospital admissions for elderly US patients with heart failure fell by nearly 30 percent over a decade, an analysis of federal Medicare data shows, a surprising finding that offers fresh evidence of progress in the battle against cardiovascular disease. The report, being published Wednesday in the Journal of the American Medical Association, is the first to document a decline in admissions in the US for the condition, an enormously costly and debilitating problem and the most common reason for hospitalization among Medicare beneficiaries.

The finding is based on data from more than 55 million patients in Medicare’s conventional fee-for-service program who were hospitalized for heart failure between 1999 and 2008. Researchers estimated there were 229,000 fewer admissions for heart failure in 2008 than would have been expected had the rate of admissions remained at 1999 levels.

As a result, the Medicare program saved $4.1 billion in hospital costs related to heart failure. Heart disease overall is still the leading cause of death in the US, and this latest research comes with caveats. For heart-failure patients who were admitted to the hospital, death rates one year after that hospitalization fell only slightly—to 29.6 percent in 2008, the last year of the decade covered by the study, from 31.7 percent in 1999.

Hospitalization rates also varied significantly by state, and the improvement for black men was smaller than that of other groups. But the gains, coming as the population ages and as obesity and diabetes—both risk factors for heart disease—are enormous public-health concerns, were a welcome surprise to some heart experts. Many attributed the improvements to better preventive measures and disease management, as well as a reduction in elderly patients’ rates of heart attack—a common cause of heart failure. About 5.8 million Americans are diagnosed with heart failure, according to the American Heart Association, which estimates that total costs for treating patients, including associated indirect costs, were $39.2 billion in 2010.

Source: Wall Street Journal, health industry

The debate is on – five congressional committees, town hall meetings, president’s speeches, claims from the left, right and the middle – wow, everyone is thinking of the broken healthcare system. It’s interesting, because while we are talking of costs and changes to the system, we may be losing sight of what we as patients can do.

So, while everyone is talking of reforming our healthcare – we thought of putting some focus on reforming our health.

When I was growing up, I learned that prevention is better than cure. But, “A stitch in time saves nine” is all but a cliché today.

Studies show that the spend on chronic diseases is a huge percentage of our total healthcare spending. On top of it, the billions in productivity loss is not even measured. Chronic disease such as diabetes, heart diseases and obesity –that can all be reduced through healthy lifestyle and timely diagnosis continue to grow at an alarming rate. Prevention being considered more expensive on face of it is delayed.

However there are conclusive studies that spending today on chronic diseases completely dwarfs the money we could spend of the right preventive programs. For that, we at DocAsap are launching a preventive care campaign to promote healthy lifestyle and preventive checkups.

So folks, its time to get your routine workouts, quit junk food and smoking and get that postponed annual health checkup, mammogram, dental checkup and flu shot. Go see your doctor for a preventive checkup.

PS: we at DocAsap continue to be committed to prevention because we believe that a stitch in time can save nine, ten or may be even more.