The U.S. health care payments industry is undergoing changes as it grapples with inefficiencies in how patients, payers and providers exchange information and money. At the same time, it must respond to economic pressures, government reforms and other dynamics while it focuses on quality, value and cost reduction.
More than $2.7 trillion in health care payments change hands in the U.S. annually – one-sixth of GDP – according to a February Web seminar, “Healthcare Payment Trends Webinar,” by Kunal Pandya of Health Insurance & Payments at Aite Payment Group. About 49% of these payments are initiated by government entities; 40% come from employer-funded private insurers; and the remaining 11% come directly from consumers. The flow of information and money is highly labor-intensive and inefficient. Efforts to simplify it are hampered by short-term cost considerations, a lack of automation and data standards and other factors.
