Reducing Administrative Burden in Medical Practice:
A Pathway to Improved Patient Access and Quality Care
By Elizabeth Schumacher, JD
Administrative burdens in healthcare have become more than just an inconvenience—they are a major obstacle to efficient, high-quality patient care. With excessive regulatory requirements, complex documentation processes, and outdated systems, physicians and healthcare providers are forced to dedicate significant time to administrative tasks rather than patient care.
The consequences? Burnout, reduced patient access, and a decline in overall care quality. If left unaddressed, these burdens will continue to weigh down the healthcare system, increasing operational costs and delaying critical treatment for patients.
But there is hope. By recognizing the urgency of these challenges and implementing collaborative, practical solutions, we can create a healthcare system that works more efficiently for both providers and patients.
The Impact of Administrative Burden on Healthcare
Administrative inefficiencies don’t just slow down paperwork—they create a ripple effect that impacts every level of care:
- Physicians are overburdened – Spending up to two-thirds of their time on paperwork rather than patient care (American Medical Association).
- Patients experience longer wait times – Delays in processing insurance claims and authorizations lead to postponed treatments.
- The personal touch in medicine is fading – When healthcare professionals are consumed by documentation, meaningful patient interactions suffer.
- Costs continue to rise – The U.S. spends approximately $1 trillion annually on administrative costs, with $200 billion allocated to financial transactions alone (PubMed Central, 2024).
- Claims processing inefficiencies – Each of the 9 billion claims submitted annually costs $12 to $19 per transaction, taking an average of 4 to 6 weeks to process. Simple claims cost $7 to $10, while complex claims reach $35 to $40 per transaction (PubMed Central, 2024).
- Prior authorization burdens – Covering 5,000 medical codes, prior authorizations cost $40 to $50 per submission for private payers and $20 to $30 per submission for providers.
- Potential cost savings – Implementing an efficient financial transactions system could save $40 billion to $60 billion annually, reducing operational inefficiencies through automation and standardized policies (PubMed Central, 2024).
For patients, the burden of a broken system isn’t just an inconvenience—it can mean the difference between life and death.
A Patient’s Battle Against the System
Julia Dars, a fitness coach and nutritionist, had spent over 15 years dedicated to health—yet, in 2023, she found herself trapped in a system that failed her when she needed it most.
Her symptoms began subtly—rapid weight loss, exhaustion, and sudden sugar cravings. But when her vision started deteriorating, she knew something was seriously wrong.
Upon returning to her home country of Belarus, Julia was promptly diagnosed with diabetes. Doctors told her she had been dangerously close to a diabetic coma. In Belarus, she was able to walk into a pharmacy and receive insulin—for free. But when she returned to the U.S., she was met with high co-pays, bureaucratic delays, and life-threatening gaps in care.
- A continuous glucose monitor? Insurance covered it—but the co-pay was $150 a month.
- Insulin? Also covered—but another $150 out of pocket.
- A simple prescription refill? She had to wait months for a doctor’s appointment to get life-sustaining medication.
In one moment of desperation, her fast-acting insulin ran out—but the doctor’s office had mistakenly sent the wrong prescription. It was Friday night. The office was closed. No insulin for the weekend.
Sitting in the pharmacy aisle, overwhelmed and in tears, she realized just how broken the system was.
Julia eventually took matters into her own hands—learning how to manage her condition through lifestyle and research. She brought her blood sugar down to normal levels and even regained her vision. But not every patient has the ability or resources to do the same.
The question remains: Why is life-saving care so difficult to access in one of the world’s most developed nations?
Practical Solutions: Reducing Administrative Burden Without Compromising Care
The key to solving this issue lies in collaboration between medical associations, healthcare providers, insurers, and government entities. Each stakeholder has a role in creating smarter, more efficient systems that reduce unnecessary workload while improving care quality.
- Standardizing Documentation and Billing Processes
One of the biggest inefficiencies in healthcare comes from non-standardized billing and documentation requirements. Every insurer has different forms, codes, and processes, creating confusion, redundancy, and excessive workload for physicians and staff.
Solution: Insurers and medical associations must work together to develop standardized billing protocols and automated systems that streamline the claims process.
Reflection: How much time would be saved in your practice if all insurance providers followed a unified billing process? - Reforming Preauthorization Requirements
Preauthorization is intended to control costs and prevent unnecessary procedures, but in reality, it often delays critical care while adding more administrative work for physicians.
Solution: Insurers can implement faster, automated preauthorization systems while allowing exceptions for urgent cases.
Reflection: How many patients in your practice have faced unnecessary delays due to slow preauthorization approvals? - Leveraging Digital Transformation in Healthcare
Technology has the potential to revolutionize administrative efficiency in healthcare. However, adoption remains slow due to lack of integration and user-friendly design.
Success Story: Cleveland Clinic implemented an AI-driven scheduling system, reducing patient wait times and increasing physician availability.
Solution: Healthcare leaders must push for AI-driven automation in claims processing, appointment scheduling, and EHR management to cut down on repetitive tasks.
Reflection: How would an intuitive, well-integrated EHR system improve your daily workflow?
The Role of Medical Associations: Leading the Charge for Change
Medical associations must take an active role in driving administrative reform. Their influence can shape policy changes, insurance regulations, and technological advancements that ease the burden on healthcare providers.
- Education & Training: Equip providers with tools to streamline documentation and navigate administrative complexities efficiently.
- Policy Advocacy: Push for legislative reforms that eliminate unnecessary paperwork and accelerate approval processes.
- Collaboration with Insurers: Work directly with payers to create clear, standardized administrative policies.
- Amplifying Physician Voices: Conduct surveys, collect real-world data, and advocate for evidence-based reforms.
A More Efficient Future for Healthcare
Julia’s story is just one of many. The administrative burden in healthcare is more than a paperwork problem—it’s a barrier to life-saving treatment.
By working together—medical associations, insurers, providers, and patients—we can reduce administrative burdens, enhance access to care, and improve healthcare quality for all.
Actionable Takeaway: Advocate for administrative reforms within your organization. Engage with medical associations, insurers, and policymakers to demand practical, patient-centered changes.
Closing Thought: Healthcare should never be a maze. No patient should have to choose between survival and financial ruin. No doctor should have to spend more time on paperwork than healing. The solutions are within reach—if we act now.
