Ironically, one of the more effective ways to reduce billing waste was when health systems (or their PE owners) decided to slash costs by laying off their coders (for everyone else who didn't live revenue cycle, a "coder" in this case is someone trained to translate medical procedures to billable CPT codes) and having nurses do billing. Suddenly there was zero incentive to optimize for reimbursement, since nurses are understandably nervous about getting sent up for inadvertent Medicare fraud.
