Pachavit Kasemsap, MD served in the military as a flight surgeon and founded a bariatric surgery program. Today, Dr. Pachavit Kasemsap works for Cigna as a medical director in utilization management.
A 2017 article published in Healthcare IT News reported that even as early as 2013, the healthcare industry has suffered from inefficiencies in terms of utility management. In the years spanning 2011 and 2013, 64 percent of physicians reported having problems determining which tests, procedures, and drugs a patient needed, and 63 percent of physicians reported having to wait several days for authorizations on drugs, procedures, and tests with 13 percent having to wait longer than a week.
These efficiencies added up for both payers and providers. For payers, the costs totaled $74 billion, and for providers, the costs totaled $31 billion, and these were only administrative costs. In total, the loss to the healthcare industry added up to $800 billion in administrative efficiencies, provider error and efficiency, duplicative care, fraud and abuse, and other areas of waste.
However, these inefficiencies can be addressed in a few ways. Even with time and budget constraints, including a 24-hour case manager that can assess efficiencies at all points of care (before, during, and after) improves the likelihood that patient receives effective, high-quality care and reduces healthcare costs. Finally, the use of automation as it relates to storing patient information can reduce duplication of services, i.e. electronic health records.
Pachavit Kasemsap 