Health Care Costs – Clinician Well-Being Knowledge Hub

CMS Proposal to Level E/M Payments Raises Concerns

NAM — Wed, 18 Sep 2019 12:50:28 +0000

This article, published in MD Edge, reports on a new proposal by the Centers for Medicare & Medicaid Services to reduce paperwork by flattening payment for evaluation and management visits coded at levels 2-5. CMS outlined its vision for change in the 2019 Medicare physician fee schedule. For most specialties, it is estimated that there will be minimal effect regarding the change. Others could potentially lose 3% of their pay, which raises concern for some specialists. While they applaud efforts to “abandon medically irrelevant charting” that contributes to burnout, they also note that there should be a fair and transparent way for doctors to get paid.

2016 Survey of America’s Physicians Practice Patterns and Perspectives

NAM — Wed, 14 Aug 2019 20:40:32 +0000

The following report, conducted by The Physicians Foundation, is based on 17,236 physician responses to a biennial survey, which inquired physician’s perception of the state of the medical profession. Key findings suggest a continued struggle among physicians to maintain morale levels, adapt to changing delivery and payment models, and to provide patients with reasonable access to care. Because physicians remain the key drivers of healthcare quality, access, and cost, how they practice and how they view their own profession is of critical importance to health professionals, policy makers, media members, and to the public.

Counting the Costs: U.S. Hospitals Feeling the Pain of Physician Burnout

NAM — Wed, 14 Aug 2019 20:39:07 +0000

The following article, published in U.S. News & World Report, briefly summarizes the causes of burnout such as the burden of data entry on electronic health records, and the costs of clinician burnout on well-being, efficiency, patient safety, and economics. It also introduces the early initiatives taking place around the United States to combat burnout.

Making an Evidence-Based Case for Urgent Action to Address Clinician Burnout

NAM — Mon, 24 Jun 2019 13:34:04 +0000

Clinician burnout is currently a public health epidemic that is threatening the quality and safety of healthcare. In the following article from the American Journal of Accountable Care, the author provides an overview of the causes of clinician burnout and offers solutions for health care systems, including staffing patterns and changes to the electronic health record system. The author also provides evidence of return-on-investment for funding invested in clinician well-being.

Estimating the Attributable Cost of Physician Burnout in the United States

NAM — Wed, 05 Jun 2019 20:35:12 +0000

Although physician burnout is associated with negative clinical and organizational outcomes, its economic costs are poorly understood. As a result, leaders in health care cannot properly assess the financial benefits of initiatives to remediate physician burnout. This article from the Annals of Internal Medicine estimates burnout-associated costs related to physician turnover and physicians reducing their clinical hours at national (U.S.) and organizational levels. The authors find that on a national scale, the conservative base-case model estimates that approximately $4.6 billion in costs related to physician turnover and reduced clinical hours is attributable to burnout each year in the United States. This estimate ranged from $2.6 billion to $6.3 billion in multivariate probabilistic sensitivity analyses. At an organizational level, the annual economic cost associated with burnout related to turnover and reduced clinical hours is approximately $7600 per employed physician each year. Together with previous evidence that burnout can effectively be reduced with moderate levels of investment, these findings suggest substantial economic value for policy and organizational expenditures for burnout reduction programs for physicians.

An economic argument for investment in physician resilience

NAM — Wed, 03 Apr 2019 17:30:52 +0000

Despite compelling, evidence-based, and practical articles emphasizing the importance of physician resilience, adopting the concept of resilience has been slow. Walsh, in a letter to the editor of Academic Medicine, explains that an economic case for investing in resilience may reap more change and details the costs of attrition and errors in medicine.

Second Annual Physician Compensation Report

NAM — Mon, 01 Apr 2019 19:04:41 +0000

The following report, conducted by Doximity, seeks to understand physician compensation to combat the growing shortage of US physicians. Drawing from over 65,000 licensed US doctors, this report focuses on the year-over-year trends in Physician compensation across Metropolitan Statistical Areas (MSAs), the gap in pay between male and female physicians, and absolute physician compensation across specialty, state, region and gender.

A Literature Review of Nursing Turnover Costs

NAM — Wed, 13 Mar 2019 18:33:17 +0000

This review article published in the Journal of Nursing Management summarizes data and trends of nursing staff turnover costs from 1990 to 2010. Inconsistencies in conceptualization and measurement of turnover, methodologies of data analysis, and approaches to cost calculations are evaluated closely and reported. The findings of inconsistencies call for further exploration of cost calculations in order to better advise executive leadership to re-evaluate institutional policies.

Emerging the EHR Purgatory – Moving from Process to Outcomes

NAM — Wed, 13 Mar 2019 16:39:12 +0000

Goroll’s Perspective paper in the New England Journal of Medicine illustrates the electronics arms race between payers demanding documentation to justify payment and EHR vendors with elaborate documentation tools. The increased time physicians have to spend in front of computers limiting patient care experience, productivity, and professional satisfaction, thereby elucidating a need to shift to a value based care model of healthcare delivery. A focus on outcomes places renewed emphasis on eliciting and recording essential elements of care. Goroll further details possible positive outcomes and push back from this shift and describes the steps the Innovation Center at the Center for Medicaid and Medicare Services has taken to revitalize our EHR.

Economics of Team-based Care in Controlling Blood Pressure: A Community Guide Systematic Review

NAM — Mon, 04 Feb 2019 16:19:07 +0000

The following systematic review examines the costs of team-based care for blood pressure control. 31 studies published between 1980 and 2012 were analyzed for intervention cost, healthcare cost averted, benefit-to-cost ratios, and cost-effectiveness. The quality of estimates for intervention and healthcare cost from each study were assessed on intervention focus on blood pressure control, incremental estimates in the intervention group relative to a control group, and inclusion of major cost-driving elements in estimates. Results show that team-based care to improve blood pressure control is cost-effective.