AMA study shows paperwork snarls up Medicare services

This story was published on May 02, 2001 on Page B1 in all editions of the Bangor Daily News

The sick have to fill out too many forms too many times, and they shouldn’t have to take it anymore, Blue Hill Hospital CEO Bruce D. Cummings said at a press conference in Washington, D.C., yesterday.

To illustrate his point Cummings spoke in a room he had lined with a single 40-page home health form he’d taped end to end. Filling out such a form once is bad enough, but having to do it again and again – even though the patient is still within the Medicare system, is unconscionable he said.

An 80- or 90-year-old person who comes to a doctor suffering from pain shouldn’t be subjected to the additional anguish of 90 minutes of paperwork, Cummings argued.

“It’s almost cruel and unusual punishment to suggest a patient fill it out,” Cummings said in a telephone interview after the press conference.

Cummings was speaking for the American Medical Association, which released a study yesterday showing that for every hour a doctor or other medical person spends with a patient, another 30 minutes is spent on paperwork.

The study, by Pricewaterhouse-Coopers, depicts a medical system buried under unnecessary forms. It found that in the typical case of an elderly woman who falls and fractures her hip:

. Every hour of emergency room care requires an hour of paperwork.

. Every hour of surgery requires 36 minutes of paperwork.

. Every hour of skilled nursing care requires 30 minutes of paperwork.

. Every hour of home health care requires 48 minutes of paperwork.

To trim the paper elephant Cummings suggests a few simple changes.

First, Medicare should have one person, or a “czar,” in charge of overseeing paperwork for all medical disciplines. Right now, service areas such as home health care, hospital care, skilled nursing care and others operate completely independently, requiring similar forms to be filled out again and again, he said.

The forms themselves are overblown, he said.

“These are conceived and developed within the regulatory apparatus and then ushered out into the field,” Cummings said.

As a second step, Cummings thinks Medicare should be mandated to test new forms in the field before requiring their nationwide use. He also believes fieldworkers should be brought in to bring some rationality to the forms.

Cummings was in Washington with more than 30 Maine hospital administrators who are attending a conference and lobbying congressional leaders for better Medicare reimbursement. Some hospital representatives met with all four members of Maine’s congressional delegation to press for changes.

As he calls for changes in medical forms, Cummings is clearly angry with the bureaucracy that results in nurses and other medical professionals being blamed for the unwieldy forms.

They are “ridiculous,” he said.

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