Private Practice Administrative Costs Influenced by Insurance Payer Mix.

Journal of Oncology Practice
Jorge M LunaWilliam D Figg

Abstract

BACKGROUND: Increased staffing and oncology drug costs per physician, combined with decreased drug revenue, have made private hematology-oncology practices susceptible to increased financial risk. We hypothesized that practices with a higher combined commercial insurance (CCI) mix would experience greater inefficiencies in insurance billing (IB) processes and higher IB administrative costs. METHODS: A cross-sectional survey was administered to a national pool of private hematology-oncology practices. Practices were identified through the ASCO online registry. Participants self-reported insurance information. T and Wilcoxon rank sum tests were used to compare high (50% or more) Medicare payer mix groups and high (50% or more) CCI payer mix groups for practice operation indicators. These tests were also used to compare denial processing cost per Medicare patient and CCI patient. RESULTS: Among the 33 practices that responded to the survey, the mean total IB administrative cost for high Medicare payer mix groups was $191,646.25 (standard deviation [SD], $173,031.63), significantly lower (P = .0454) than the mean for high CCI groups at $476,280.00 (SD, $475,408.57). The mean annual cost per IB support staff member was significantly...Continue Reading

References

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Citations

Nov 4, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Ann M BergerSangeeta Agrawal
Jul 27, 2021·PloS One·Mursal GardeziLee E Rubin

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