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Costs and Benefits of Physician Practices' Interactions with Health Plans
What are costs to physicians of administrative complexity in their interaction with payers? The researchers examined the administrative burden associated with physician practice interactions with health plans using three approaches: (1) they developed a national estimate of the administrative “costs” for U.S. private physician practices generated by their interactions with multiple health plans/payers; they will simultaneously develop estimates of the costs for analogous interactions in Canadian physician practices and for Kaiser Permanente practicing physicians; (2) they also developed order of magnitude estimates of the “benefits” of administrative complexity; and (3) they surveyed U.S. health plan and physician practice leaders to determine if there is common ground on eliminating or simplifying administrative complexity. The objective of this project was to provide the best estimate to date of the costs to physicians of administrative complexity in their interaction with payers and to give a qualitative sense of the extent to which physicians’ costs associated with administrative complexity are balanced with benefits.
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