Smart-Care: Save $500 billion a year without cutting health benefits or services

Few people are happy with the current situation of the U.S. being crippled by health care, which is now 18 percent of our country’s economy. We pay more per capita for health care than any other country in the world, yet we don’t live as long as many others where costs are lower. For example, in 2013 when we spent 50 percent more than the Swiss, who live on average four years longer, U.S. males ranked only 26th out of the 36 member countries of the Organization for Economic Cooperation and Development (OECD), right below Slovenia.

Part of the problem is that we lose an average of 31 percent of each health care dollar to administrative costs. Some providers do not accept health insurance, as they have found it too difficult or expensive to complete an elaborate transfer of information to get complex benefits and billing correct to eventually get paid.

All practitioners struggle with the problem of getting and providing patient records in a timely and efficient manner. There is much expensive duplication of effort in our current system, whether it be lab tests and procedures, or each provider asking the patient for their history all over again. Administrative problems raise the cost of care and reduce funds available for other needs, causing discontent and decreasing our ability to compete in the world economy. Fewer of our brightest graduates choose health professions, leading to an erosion of future care.

A Smart-Care system can reduce these problems and costs, while actually helping to improve care without reducing benefits or services. Smart-Care will use secure online technology to make patient records available to all providers through the cloud along with insurance coverage, billing and reimbursement. Other countries with lower costs and better results do something similar.

This should produce savings of up to 15 percent or more, which would be over $500 billion a year and yield a 2.7 percent boost to the entire United States economy. This is estimated to save the government over $35.25 billion per year just in lower costs of government employees’ health care coverage; there will be other savings as well. With Smart-Care, waste is cut by accessing the health information system at the start of an encounter using the patient’s magnetic card or number along with passwords and possible biometric protection. Benefits are clearly available at the point of service and, after the visit, a brief record of care is uploaded in return for prompt online payment. Everything stays up to date and readily available to improve care. The costs to implement the program should be less than the first year’s savings, and the program once initiated can be self-supporting with modest non-profit transaction fees similar to, but less than, those of a credit card payment.

Smart-Care can build on existing health data exchanges, which typically only include hospital records, by adding national standards for records, along with benefits coverage and prompt online reimbursements. The online availability of free basic records will make it easy for all providers to participate. More funds will be available for other needs, improving the quality of life in many ways beyond health care by reducing the burden of health care on our economy.

Some of the many benefits of immediate online record availability, insurance coverage and the ease of prompt online payments include:

  • Increased access to care with reduced costs;
  • Less administrative time and expense;
  • Happier providers and patients;
  • Ready availability of records to coordinate care;
  • Quick look up of organ donor status, health care power of attorney and living wills;
  • A patient opt-in system to facilitate research, which otherwise would not be possible;
  • And assistance with lifesaving history when an emergency room patient can’t provide information as after an overdose, accident or stroke.

For a change this big, government must lead the way by: helping to set the standards, giving start up grants and requiring all government employees to be covered by insurance using Smart-Care standards within three years.

The process would start with studying the systems in use elsewhere to develop the standards for the U.S. within a year. Grants can be provided to companies to develop the free online basic records. Once several private carriers voluntarily agree to offer the program in a service area, they will have lower costs and a competitive advantage; others will follow suit.

Congress’ current proposals to lower health care spending would result in reductions or loss of benefits for millions. Smart-Care is a non-partisan way in which we can help protect funding for all Americans and bring health care into the 21st century.

Dr. Bruce T. Taylor (BTaylor@TaylorService.com) is a real estate developer, board certified psychiatrist and distinguished life fellow of the American Psychiatric Association. More information on Smart-Care is available online at www.Smart-Health-Care.com.

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