“The hassle factor of U.S. health care is something many experts once dismissed as annoying but mostly inconsequential. This study suggests it matters a lot.”

Jonathan Cohn, Policy and Politics reporter, Huffington Post

High administrative complexity is a central feature of the U.S. health care system. Largely overlooked, patients frequently do administrative work that can create burdens resulting in delayed or foregone care.

A new study in Health Services Research (subscription required) finds administrative complexity in the U.S. health care system has consequences for access to care that are on par with financial barriers like copays and deductibles. In other words, we pay for health care in two ways: in money and in the hassle of dealing with a complex, confusing, and error-riddled system. Both are barriers to access. Here are some of the key findings from the study:

• Nearly three-quarters (73%) of people surveyed reported doing at least one healthcare-related administrative task in the past 12 months.
• Nearly one-quarter (24.4%) of survey respondents reported delaying or foregoing needed care due to administrative tasks.
• The administrative burden has implications for equity. It falls disproportionately on people with high medical needs, and existing racial and socioeconomic inequities are associated with a greater administrative burden.

“For people who are chronically ill, it can be like a full time job just keeping up with every hoop you have to jump through, insurance issue that wasn’t billed correctly, and sometimes having to contact people in government to report when things are being done incorrectly.”

Patient with multiple chronic conditions on Twitter

My take – Navigating the U.S. health care system can be frustrating for anyone. Still, for adults with chronic medical conditions, the frustration can become overwhelming as they juggle multiple providers, medications, and treatments. My contention has long been that health care providers who eliminate friction from the process of delivering care will stand apart in their served markets. Much has been written on the topic. Here are my seven common recommendations for removing friction from the care process:

• Explore viable alternatives to paper forms and faxes. Develop an online “short form” registration process, which contains all of the information required to preregister a patient.
• Eliminate data silos so that the data from your online “short form” flows across the enterprise, thus eliminating redundant data entry requirements.
• Implement open-access scheduling across the enterprise. Open-access scheduling, which has been around for years, centers on the use of entirely open schedule templates, few restrictions on appointment types, and the elimination of most future scheduling of appointments.
• Expand care settings and times to meet the needs of your patients. Many organizations have expanded primary care hours in the evenings and on weekends to meet patient preferences and compete with “convenient care” clinics. Similarly, health systems have begun to align with urgent care centers and even integrate them into their primary care networks.
• Optimize the use of patient contact centers to streamline care coordination and communication. Organizations are turning to comprehensive contact centers (either insourced or outsourced) to manage the increasingly complex business of efficiently getting the patient connected to the right provider. Patient contact centers can house a broad range of services, including clinic operations, post-acute coordination, clinical services, and e-Care facilitation. Ultimately, when utilized effectively, these contact centers can provide both clinical and non-clinical support to patients, telephonically as well as virtually.
• Review and optimize your patient portals. Portals allow patients to take a proactive role in managing their healthcare, resulting in potentially more effective prevention strategies and reductions in unnecessary visits. They also give patients access to the information that they have enjoyed for years in other industries, such as banking and insurance.
• Expand the use of patient navigators across the enterprise. Patient navigator programs are aimed at guiding patients through the convoluted healthcare system and providing an optimal experience. In their most advanced form, navigators are similar to case managers who help coordinate every step along the care continuum, including administrative and clinical components. They may find the appropriate providers and schedule appointments, coordinate the transfer of health information among providers, educate patients about the next steps in a treatment plan, provide after-hours support when physicians or clinic staff are unavailable and empower patients to take a more active role in their care.

Efficiently and effectively addressing the health of the population and remaining competitive in the marketplace requires healthcare organizations to proactively pursue and embrace innovative strategies for eliminating friction from the process, thereby expanding access to health services.