Strategies to Alleviate the Administrative Burden in Healthcare

Navigating everything that goes into healthcare administration can be daunting. While necessary, the responsibilities of paperwork, compliance requirements, and insurance coordination can be overwhelming for patients and healthcare providers alike. 

The burden of healthcare administration is a multi-faceted challenge—one that can affect healthcare costs. According to a research brief published in Health Affairs, administrative spending accounts for up to 30% of total healthcare costs in the United States. This figure underscores the need for streamlined processes and a closer examination of how to reduce these costs. 

Plus, time spent on administration can eat into a clinician’s time to see patients, affecting patient experience. One study found that physicians spent twice as much time on paperwork as they did with patients.

How can healthcare providers begin to combat these challenges in their practice? What are some strategies that can improve operational efficiency?

In this article, we’ll discuss the impacts of administrative burden on the health system, common examples of this issue, and some solutions that can be implemented in a clinical practice.

What is the Administrative Burden in Healthcare?

Administrative burden refers to the time and effort physicians, health care providers, clinicians, and administrative staff spend on administrative clinical support functions that detract from direct patient care. 

Examples of such tasks may include:

• Documentation requirements for patient visits and treatment plans
• Navigating complex health insurance claim procedures and disputes
• Managing the patient referral process to specialists or other healthcare facilities
• Coordinating care across multiple providers, which often involves a significant amount of paperwork and communication
• Handling prescription refill requests and prior authorizations for medications and procedures
• Keeping up with the continuous updates in coding and billing regulations that require ongoing education and training

These tasks, while necessary for the functioning of healthcare practices, can consume a substantial portion of the workday, leaving less time for patient care.

Administrative waste refers to the excessive or unnecessary healthcare administrative expenses in the healthcare system that do not contribute to patient care or outcomes.

The Impacts of Administrative Burden

Administrative burden has impacts both from the physician and healthcare staff perspective as well as patient perspective. Below we’ll explore the impacts and how addressing administrative burden is part of a patient-centered approach to healthcare.

A few of the areas we discuss are:

• Physician burnout
• Economic impact
• Business impact
• Patient experience

Administrative burden not only contributes to physician burnout and impacts patient care, but also consumes a significant amount of total national health expenditures. 

Physician Burnout

Over 60% of physicians have reported experiencing at least one symptom of burnout (AMA). Among the leading causes, work overload was significantly associated with burnout (Journal of Internal Medicine). 

Read more: Tackling Physician Burnout: Strategies for Well-Being and Resilience

The Economic Impacts

On the economic front, administrative burdens are a major contributor to health spending. According to a Health Affairs research brief, at least half of administrative spending is wasteful, and could be addressed with more streamlined workflows. According to one McKinsey report, potentially $265 billion could be saved annually in unnecessary healthcare spending costs.

These costs can take the form of non-clinical spending, healthcare cost inflation, budgetary strain, and resource diversion. In other words, resources are spent on administrative tasks that could otherwise be directed to improving patient care.

Patients also may encounter financial burdens due to the complexity of healthcare administration. Understanding insurance requirements can involve a steep learning curve, made more complicated for patients with barriers such as language, cognitive conditions, or caregiver role strain. 

Incomplete documentation, for example, can lead to insurance denials, which puts the cost of healthcare back on patients. However, one article reports that 56% of Medicare Advantage plans had improper payment denials. Additionally, 45% of denial letters contained errors or omitted crucial information needed for appeals. Without knowledge of the appeals process, patients potentially take on costs that could otherwise be avoided. 

The Business Impacts

Administration is a necessary part of medical practice workflows, and yet it can become a burden that slows down other essential workflows, such as patient care.

Examples of the business impacts of administrative burden include:

• Increased workload: Administrative tasks can lead to a heavier workload for staff, when support for these processes is lacking. Research published by the Canadian Federation of Independent Business found that physicians spend 18.5 million hours on unnecessary administrative tasks each year. 
• Lost time: Excessive time spent on tasks like scheduling and obtaining prior authorizations is time taken away from patient care. The Physician Administrative Burden Survey provides insights into the ways administrative tasks detract from patient care, highlighting that the time healthcare professionals spend on paperwork and bureaucratic responsibilities could otherwise be used for direct patient interactions.
• Staff turnover: Burnout caused by administrative burden can lead to staff turnover. Nearly half of all physicians who leave the profession attribute their departure to burnout (The Century Foundation).
• Budgetary strain: Turnover leads to the need for hiring more administrative personnel, impacting budgets. The Bureau of Labor Statistics employment projection report suggests a growing demand for healthcare administrative professionals.

The Patient Experience

From the patient’s perspective, the administrative burden directly translates to less time with their healthcare providers and more time dealing with paperwork, phone calls, and insurance issues. This shift away from patient-centered care can lead to poorer health outcomes and decreased satisfaction with the healthcare experience. 

• Potential for human error: The possibility of mistakes in billing, health insurance claims, and patient records can cause confusion and frustration, potentially compromising patient trust and satisfaction. Research by JAMA found that 14% of patients have changed physicians because of mistakes. 
• Delayed care: Administrative burdens can also delay patients’ access to care. One survey found that 24.4% of patients experienced delayed care due to having to perform an administrative task (Health Services Research). For example:

• Prior authorization delays: Necessary medical procedures are delayed due to lengthy prior authorization processes.
• Adverse health outcomes: Patient health may be impacted due to administrative delays and inefficiencies.
• Medicaid 'churn': Patients transitioning between eligibility statuses face significant administrative challenges, disrupting their continuity of care.

Examples of Administrative Burden

Looking at specific examples can help us to better understand the administrative burden in healthcare. 

Record keeping. Keeping detailed records is essential to patient care. Meticulously maintaining patient histories, recording detailed treatment plans, and updating patient information with precision are important tasks. 

When done manually, or recorded on paper, these tasks can be time-consuming and prone to error. A study in the Annals of Internal Medicine found that physicians spend a large portion of their day using electronic health records (EHRs) to document and support medical care. Fortunately, automated and digitized record-keeping is becoming more ubiquitous.

Scheduling appointments and communicating with patients. Similarly, manual scheduling potentially requires additional healthcare staff and excessive time coordinating with patients via email or phone. Sending reminders and answering ad hoc patient queries can quickly accumulate.

Coordinating with health insurance providers. Verifying coverage, submitting claims, and resolving billing issues are another essential but potentially time consuming and frustrating administration responsibility. One 2019 study found that insurers lacked “awareness of care coordination presence within practices,” indicating a potential disconnect in understanding the administrative workload. Better coordination between payers and providers is called for here.

Administering pen-and-paper tests. Whether cognitive tests, mental and behavioral assessments, or surveys, paper assessments can be easier to memorize, susceptible to scoring errors, and require additional work to manually administer then upload the information to patient records. 

Digitizing the Assessment Process

Making the switch from pen-and-paper assessments to computerized versions can reduce the time spent administering, scoring, and recording assessments—and free up more time on face-to-face patient care.

Creyos offers computerized cognitive testing as well as standard mental and behavioral health questionnaires. By accessing these through a central health platform, healthcare providers get an automatically generated report of a patient’s scores that are easy to upload to an electronic health record (EHR). 

Assessments can be administered in-clinic or even via telemedicine, reducing the need for in-person appointments or optimizing the time that a clinician has to spend interpreting results with the patient during a visit. The convenience of Creyos' at-home or in-clinic testing can lead to increased patient compliance and timely data collection, which in turn could expedite diagnoses and treatment plans. 

Read our case study to learn how Yukon Neurology achieved 99% patient compliance for cognitive testing while saving up to 4 hours per patient to complete comprehensive neuropsychological testing.

Reducing Administrative Costs with Operational Efficiency

Despite the significant challenges presented by the administrative burden in healthcare, numerous potential solutions can help improve operational efficiency. By implementing these solutions, healthcare providers can improve the quality of care and reduce administrative costs.

Integrating Telehealth Workflows

Healthcare providers can now deliver services remotely—a shift that can lead to a significant reduction in administrative tasks. More than 70% of physicians expressed an intention to incorporate telehealth into their practice.

Integrating telehealth into healthcare practices can simplify or automate:

• Appointment scheduling
• Record keeping and session notes
• Patient-provider communication

Additionally, the adoption of specialized telehealth equipment can enhance these processes by providing the necessary tools for efficient remote consultations and treatments. Overall, telehealth presents a powerful strategy for healthcare providers looking to reduce administrative workload and focus more on patient care.

Automating Communications and Scheduling

Automation can reduce the time and effort required for administrative tasks, freeing up resources for patient care. For example, automation can reduce the potential for errors, improving the accuracy and reliability of administrative processes.

Using computerized standardized tests can help:

• Streamline the testing process
• Reduce the potential for errors
• Provide instant results, speeding up the diagnostic process

Integrations for Electronic Medical Records (EMRs)

Some of the leading provider frustrations with EMRs have to do with the time spent manually inputting patient information, complicated processes for updating and adding to these records, or having to interpret data that’s not presented in a user-friendly way.

Integrations can help automate the more time-consuming elements of EMR management, and help: 

• Streamline patient record-keeping
• Improve the accuracy of patient information
• Enhance communication between healthcare providers
• Provide valuable data for quality improvement and research

Generative AI 

Generative AI is poised to play a pivotal role in alleviating the administrative burden in healthcare. This advanced technology harnesses the power of machine learning and natural language processing to automate and optimize a wide range of tasks that traditionally require significant human effort.

According to an article in the Medical Futurist, one of the primary uses of artificial intelligence in healthcare is managing data. AI can be helpful when handling the collection, storage, and tracking of data, which is the initial step toward transforming current healthcare systems. 

Considerations for use:

• Privacy and security: Implement AI systems with a focus on protecting patient information.
• Human expertise augmentation: Ensure that AI supports, rather than replaces, human healthcare professionals.

By integrating generative AI, healthcare practices can achieve substantial improvements in operational efficiency and patient care quality.

Final Thoughts: Mitigate Administrative Expenses

Addressing the administrative burden in healthcare goes beyond just improving efficiency—it’s pivotal in transforming the healthcare landscape. When we reduce administrative burdens, we create a ripple effect that touches every aspect of healthcare—from cost savings to improved health outcomes.

Strategies such as strengthening payer-provider collaborations, simplifying the patient’s financial experience, and implementing AI technologies hold immense promise. 

Creyos Health was also designed to deliver robust cognitive assessment while improving operational efficiency. Scientifically validated testing methods that are then instantly and automatically compiled into an easy-to-interpret report can drastically boost the quality of patient care while easing administrative burden for providers.

Navigating the healthcare system shows that dealing with administrative tasks is a big challenge. It requires a concerted effort from all stakeholders—from healthcare providers to policymakers. But, with the right strategies and a commitment to change, we can work towards a healthcare system that is more efficient, more effective, and more patient-centered.

Frequently Asked Questions

What is the administrative burden in healthcare?

The administrative burden in healthcare encompasses non-clinical tasks like billing and compliance requirements, which consume time, money, and resources in the healthcare system.

How do administrative burdens impact the healthcare system?

Administrative burdens in the healthcare system can result in increased costs, reduced efficiency, and negative impacts on patient care. Additionally, they disproportionately affect certain populations, such as individuals with disabilities or lower income levels.

What are some potential solutions for reducing administrative burdens in healthcare?

To reduce administrative burdens in healthcare, potential solutions include integrating telehealth workflows, automating communications and scheduling, using computerized standardized tests, and implementing tools with EMR integration. These measures can help streamline processes and improve efficiency in healthcare administration.