Wednesday, June 24, 2009

Computer Billing in Health Care

First published on

The Obama Administration is described as computer savvy. They apparently made excellent use of computer technology during the election campaign and continue to apply computer technologies in their White House duties. They have suggested over hauling America’s health care records system by computerizing records and billing, and reducing or eliminating paper billing and records. America’s health care system has lots of paper to save, but there is reason to worry about jobs.

Monthly employment in health care establishments averaged 14.6 million jobs in 2008 for health care sectors in ambulatory care, hospital care, nursing and residential care. The jobs in these sectors can be divided among three groups of occupations. The first is health care practitioners who are mostly doctor, dentist, pharmacist, nurse, therapy and technology jobs. Health care practitioners actually deliver health care to patients and the jobs tend to have college and professional degree requirements. Few can be performed without a license.

Health care practitioners are the biggest segment of health care with 5.7 million jobs, 2.2 million of them nurses. Next are health care support occupations. All of them have aide, assistant or attendant in their job title: nurses aide, therapy assistant and so on. Jobs in support occupations are 3.1 million of the 14.6 million of the health care total. The third segment might be called administration and overhead, which are jobs in managing, record keeping and billing. These are 5.8 million jobs.

In other sectors of the economy, bills tend to be a two party transaction between a customer and a vender, but seldom so in health care. One illness or injury starts a billing shuffle through separate bureaucracies at hospitals, laboratories, clinics, HMO’s, PPO’s, IPO’s, but also private insurance companies, independent billing agencies and bureaucracies at Medicare, Medicaid, Social Security, workmen’s compensation or the Veterans Administration. Medicare, Medicaid and workmen’s compensation are federal programs with federal bureaucracy, but also administered by the states through 50 separate bureaucracies.

More health care in a paper world brings growth to jobs as financial clerks and information and records clerks, which are bill and account collectors, billing and posting clerks, bookkeepers, office clerks, receptionists, and secretaries. Those jobs exceed 2.6 million for those who work within the health care industry sending out the bills. It doesn’t count the insurance company or government bureaucracy jobs for the people who take them in.

Computerized billing would lead to standardization and cost saving efficiency and better and more detailed records. It should be done, but like many good things it will have noticeable side effects. At the Obama administration jobs will be a bigger problem than they may realize.

1 comment:

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