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US physician practices spend 4 times Canadian practices
Date:8/4/2011

NEW YORK (Aug. 4, 2011) -- Physicians in the United States spend nearly four times as much dealing with health insurers and payers compared with doctors in Canada. Most of the difference stems from the fact that Canadian physicians deal with a single payer, in contrast to the multiple payers in the United States.

These findings are published in the August issue of the journal Health Affairs -- the result of a research collaboration among Weill Cornell Medical College, Cornell UniversityIthaca, the University of Toronto, and the Medical Group Management Association.

Administrative costs are high in the United States due to the fact that different payers have different prior authorization requirements, pharmaceutical formularies, and rules for billing and claims payment, the researchers report. Conversely, physicians in Ontario (where the investigators conducted their survey of Canadian physician practices) generally interact with a single payer that offers one product and more standardized procedures for billing and payment, and that does not routinely require prior authorization of medical services for patients.

"The major difference between the United States and Ontario is that non-physician staff members -- nurses, medical assistants and clerical staff -- in the United States spend large amounts of time obtaining prior authorizations and on billing," says lead author Dr. Dante Morra, medical director of the Centre for Innovation in Complex Care and assistant professor of medicine at the University of Toronto.

As a result, say the investigators, per capita health spending in the U.S. is 87 percent higher than in Canada -- $7,290 vs. $3,895 annually. Administrative costs incurred by U.S. physicians and staff are estimated to be at least $82,975 per physician each year.

"If U.S. physician practices had administrative costs similar to those in Canada, the total savings for U.S. health spending would be about $27.6 billi
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Contact: John Rodgers
jdr2001@med.cornell.edu
212-821-0560
New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College
Source:Eurekalert

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