Healthcare Payments: An Issue Potentially Under the Industry’s Control
Report Summary
Healthcare Payments: An Issue Potentially Under the Industry’s Control
As U.S. healthcare payments grow at an alarming rate, industry stakeholders must act to provide improved, payment-focused solutions.
Boston, MA, September 21, 2009 – A new report from Aite Group, LLC provides details on the high level of complexity surrounding healthcare payments. The report identifies the key stakeholders involved in the industry, and what they are doing to alleviate healthcare payment issues. It also reviews the prominent solutions aimed at creating best practices in healthcare payments in the market today.
In 2008, the U.S. healthcare industry accounted for one-sixth of the overall GDP, and processed more than US$2.2 trillion in payments. Given that healthcare payments are growing at an alarming rate of 9% CAGR, the healthcare payments market is estimated to double in size by 2016, reaching US$4 trillion.
Given these numbers and the increasing pressure on the system, various stakeholders - the federal government, state governments, health plans, financial institutions, employer groups, clearinghouses and healthcare vendors - have collaborated and are working to develop consistent and more highly automated payment-focused solutions to tap the huge revenue potential that this market offers, while reducing costs for medical associations and hospitals. The group's major emphasis is to move healthcare payments processing to an electronic environment to reduce costs and increase financial efficiencies. Although some of these solutions may be effective in the long term, efforts thus far have generally created more problems than efficiencies by adding another layer of complexity and cost to an already complex system.
"Healthcare payments has been recognized as one of the top three challenges plaguing the healthcare industry, and the only one that is potentially under the industry's control," says Kunal Pandya, senior analyst with Aite Group and author of this report. "The complex process needs to be streamlined via automation and standard best practices to benefit different stakeholders involved in the process. The multiple stakeholders need to place more emphasis on process automation, which will lead to reductions in bad debts and revenue cycle times while increasing profitability for providers."
This 34-page Impact Report contains 11 figures. Clients of Aite Group's Health Insurance service can download the report.