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.
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:
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.
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:
Administrative burden not only contributes to physician burnout and impacts patient care, but also consumes a significant amount of total national health expenditures.
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
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.
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:
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.
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.
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.
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.
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:
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.
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:
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:
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:
By integrating generative AI, healthcare practices can achieve substantial improvements in operational efficiency and patient care quality.
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.
The administrative burden in healthcare encompasses non-clinical tasks like billing and compliance requirements, which consume time, money, and resources in 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.
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.