December 02, 2011
Vermont: State with Single payer system
“Single-payer health system” which was passed in May 2011 by the Vermont governor, expects to accumulate savings of 24.3% of total health expenditure between 2015 and 2024, according to Harvard economist William Hsiao. Vermont is to be the first state in USA to implement this system, which will move many state residents into a publicly financed insurance program.
Single-payer system: is a healthcare financing system, run by the state, providing universal coverage to all the residents, where both the collection of funds; and the reimbursement are the responsibility of the government. Funds are collected mainly in the form of taxes by the government, and the government reimburses healthcare providers- doctors, hospitals, etc.
On the upside, in a single payer system consumers have various benefits over private insurers like:
Nonprofit compared to private insurers where overpaid management is mainly interested in making profits
Doctors and hospitals need to interact with only one payment entity
The funding is obtained through taxes in a fair manner
Costs are controlled as the level of health spending is determined through a public process.
Consumers can have a free choice of doctor or hospital
Savings are used by people for other needs and patients need not worry about healthcare cost
Relief of the health care burden on businesses will help stimulate the economy and improve the global competitiveness of U.S. businesses. Lower healthcare costs will help reduce the prices of products, and US companies will be able to compete easily with foreign companies
According to a Commonwealth Fund report, single payer would create about 3,800 new jobs and increase the state's total economic output by more than $100 million in 2015 and can save Vermont households and employers nearly $200 million in the first year alone.
However, critics fear that moving to a single-payer system in Vermont would create huge budget deficits, while some business owners are concerned about legal and fiscal challenges. Health care advocates feel the law should be clearer about not having copayments and deductibles. Rutland City Treasury is of the view that the administration is over-estimating the cost savings a single-payer system will deliver and the state is likely to run budget deficits of 300-million dollars a year.
Implementation of this herculean task will finally depend on groundwork, overcoming certain legal challenges, challenges from self-insured employers, etc. A report depicts consumer concerns about details regarding medical and pharmaceutical benefits covered under the system, cost covered by patients, etc. There will be winners and losers once this system is implemented and solutions will have to be provided. Physicians will have only one entity to bill: the government, but they will need to be updated with all the necessary legal data, medical benefits, deductibles, well informed about self-insured employers, etc. to guarantee accuracy in medical billing and coding.
Single payer or Multi- payer systems, physicians do end up spending a lot of their time supervising Medical Billing functions in order to keep their practices profitable. Moreover the pressures of evaluating the extent of change in single payer exchange and interaction can drive a practice to way more administrative jobs than anticipated.
Physicians can benefit vastly by hiring or outsourcing to experienced medical billers and coders, who can provide the services and in-depth research required while transitioning to another payer system. Medicalbillersandcoders.com, the largest consortium of Medical Billers and Coders, has a vast talent pool of billers and coders who can help in understanding how these changes will affect medical practices and will prepare Vermont Healthcare Providers for a smoother transition to the single payer system.
Revenue Cycle Management