“It’s the prices, stupid.”
– a group of public health and policy experts in 2003, on
why U.S. healthcare spending is so high
The U.S. spends more per person on healthcare than any other developed nation, and it’s not because ours is higher quality or utilized more often by more people. Rather, it’s because the prices are higher.[1,2]” If only those higher prices correlated with higher life expectancy or lower rates of morbidity (i.e., illness and injury). Alas, they don’t, and the reason is widespread inefficiency in the U.S. healthcare system, and in particular healthcare administrative waste. For example:
- A staggering 60% of the U.S. healthcare industry is currently employed in administration, as opposed to providing patient care,[3]
- The average physician spends approximately half their day on administrative tasks.[4]
Such inefficiencies amount to approximately $935 billion in annual spending. It’s a terrifying figure, even before you consider it represents as much as one-quarter of all dollars spent on U.S. healthcare. With the U.S. still the world’s economic leader[5], the question is, what’s really going on here?
That, along with what can be done to turn things around before losing even more ground, is the focus of this quarter’s issue of Exela’s thought-leadership publication, PluggedIN: Tell Us Where It Hurts: How Tech Can Heal Healthcare. In it, we address the scope of the problem, its historical context, what’s been done thus far to address it, and why, as The Everest Group notes, “inefficiency remains pervasive in healthcare,” despite massive spending on both the part of the government and private interests.[6]Ultimately, we offer solutions—real world solutions ready to be implemented right now.
How do we know? Because we at Exela have the solutions and are ready to deploy them. As Everest notes in its 2019 Healthcare Business Process Automation Solutions PEAK Matrix Assessment,[7]Exela has been successfully prioritizing addressing healthcare’s inefficiencies—our innovative, AI-enhanced and well-priced solutions earning us a place at Everest’s “Major Contender” table in the healthcare space. Those solutions address the full gamut of challenges facing the healthcare industry, including:
- Medical coding
- Information release
- Claims processing
- Claims adjudication
- Provider data management
- Eligibility verification
- Revenue integrity
Our solutions also address challenges common throughout all industries, including:
- Billing and presentment
- Liquidity management
- Human capital management
- Lobby and reception management
- Mail services
- Print services
- Marketing Execution
Perhaps most importantly, however, they address the fundamental first “mile” along any organization’s journey into the process of business process automation/digital transformation: turning the vast and ever-increasing abundance of information in that organization’s possession, in whatever form it exists, into productive assets that can enter automated workflows for cost savings and be leveraged for the increased revenues. That requires both a macro-level of information governance and implementation of a process for enterprise information management. In the healthcare space, Exela offers comprehensive health information management solutions, tailored to healthcare’s specific challenges and goals.
PluggedIN is Exela's thought leadership publication, providing fresh insights from the cutting edge every quarter. Subscribe. Plug in. Upgrade your mind.
[1] https://www.healthaffairs.org/doi/full/10.1377/hlthaff.22.3.89
[2] https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05144
[4] https://www.focus-economics.com/blog/the-largest-economies-in-the-world
