Vol. 13 •Issue 12 • Page 10
AAMT Track
Cutting Medical Transcription Costs Can Impact Your Bottom Line
A stroll through today’s transcription marketplace has become something akin to a trip down the aisles of your neighborhood Wal-Mart. If we were to look closely at the picture of that marketplace, we would see the same clamor for customer approval, the same pretty packaging and the same tireless attempts to outwit, outplay and outlast the competition. And, unfortunately, we would probably see the same cherubic avatar vigorously “slashing” prices with that ever-present friendly smile. The demand for bottom-dollar transcription pricing by health care providers everywhere has drastically changed the face of the industry, and while the cost of transcription may be lower, the price the entire health care community is paying for that decision is high, indeed.
At the core of this issue is the assumption on the part of the health care provider that transcription has little realized fiscal value. It is typically viewed with the same begrudging attitude that is applied to the payment of malpractice insurance, a necessary but resented evil. It is an expense line item in any provider’s budget; an item that must be monitored, controlled and trimmed where possible. As HIPAA and other influences propel the industry toward greater documentation demands, the potential for that line item to increase exponentially inherently exists, and this has understandably raised the bar of customer expectation where transcription pricing is concerned. Today’s health care provider wants greater volume coverage under tighter turn-around time (TAT) restrictions and at a lower cost. Oh yeah — and without compromising quality.
Well, what today’s health care provider wants is, quite frankly, impossible. We are all (health care provider and transcription services provider alike) in quite a conundrum. Transcription service owners find themselves more and more asking the inevitable question, “Which do you want? Lower cost or quality?”
How does demanding lower cost for transcription negatively impact the health care community as a whole? The most fundamentally ungrasped concept in this equation is the pure complexity of the process. Transcription is, quite simply, not easy. Finding qualified, highly skilled medical transcriptionists to provide quality documentation under tight TAT restrictions is like finding that proverbial needle in the haystack. Like any skill-specific professional, an individual whose skill set is that unique and difficult to find is by that very nature in high demand. And, as any economics professor will attest to, demand equals money. Any commodity in high demand is going to cost more — period.
When the demand cost for labor is high and the demand pay for services is low, it doesn’t take a mathematician to realize that the one providing services has been quite effectively squeezed out of profitability, making provision of services a rather moot point for that provider. The inevitable result is compromise for all parties concerned. The health care provider, by not recognizing the inherent value of quality documentation, agrees to buy a substandard product at a discount price. (Would you believe that there are actually some companies out there who sell “discounted” pricing for documents of lower quality standards?)
It is critical for all health care providers to understand that the real issue is value. While transcription may be an expense line item, it is important for those providers to recognize that transcription is also an uncategorized income line item. The direct impact of quality transcribed documentation on the reimbursement process is inarguable; it is just unfortunately difficult to quantify in any convincing way. Trans-cribed documentation has “income” value in terms of potentially saving an institution money each year in legal fees associated with malpractice suits where a provider’s documentation of care is called into question. Transcribed documentation impacts continuity of care, the fiscal benefits of which are difficult to measure, but it must be assumed that a higher quality of care overall ultimately saves an institution money. Certainly, as stated above, the greatest fiscal impact of transcription is in the dramatic way it facilitates the coding, billing and reimbursement process. A transcribed document, quite frankly, has greater reimbursement potential by the very nature of its detail and clarity.
The point in all of this is that just as quality transcription can positively impact those fiscal areas noted above, the converse is necessarily also true. Turning over something as profoundly critical as a patient’s documentation to the “lowest bidder” is going to yield nothing but the bottom of the barrel. The result may be a timely document, but the chances of it being of highest quality are very slim. The skilled practitioners of this trade, as is true of health care providers themselves, will not accept a substandard wage for their services, and a transcription service that is asked and agrees to deliver it all (volume coverage, TAT and quality) for peanuts is probably going to deliver just that — peanuts. The old adage that “you get what you pay for” rings as true in transcription as in any other area of economics. And ultimately you will pay for a medical record depository filled with peanuts. Those peanuts will not yield reimbursement or risk management dividends.
It is past time for health care providers to recognize the value of quality documentation to patient care and reimbursement and to demonstrate that acknowledgement by committing the fiscal resources necessary to ensure it.
Lea M. Minkley is an MT service owner in Jacksonville, FL, and a current member of the AAMT Board of Directors.
