Blog | Wednesday, July 20, 2016

The argument for time based billing


In 2003 (yes this blog is that old) I wrote this piece, “Billing like lawyers.”

Then, Bob Wachter, MD, tweeted this article, “Time-Based Billing: What Primary Care in the United States Can Learn From Switzerland.”

Time-based billing may offer a simplified payment method that maintains physician autonomy and sense of professionalism. For smaller primary care practices that may not organize into accountable care organizations, time-based claims may offer an alternative means to align payment with meaningful work while simultaneously simplifying documentation and billing. Alternatively, within accountable-care organizations, time-based billing could be used as a physician reimbursement alternative to more common approaches such as volume-based incentives, salary, or pay for performance.

Our current billing processes discourage spending adequate time with each patient. As I have written repeatedly for the past 14 years, patients need us to spend the proper time attending to their needs. Time-based billing has made sense for many years, yet the idea never gains traction in the U.S. Please read the JAMA Internal Medicine article and let us know what you think.

db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Regional Associate Dean for the Huntsville Regional Medical Campus of UASOM. He still makes inpatient rounds over 100 days each year. This post originally appeared at his blog, db's Medical Rants.