Rising U.S. healthcare costs are reaching crisis levels. The United States spends more on healthcare per capita than any other country, and total spend as a percentage of gross domestic product (GDP) is increasing annually. In 2018, healthcare costs comprised 17.7% of total GDP. By 2028, this is expected to increase to nearly 20%, totaling $6.19 trillion.1
This playbook covers:
- The complexities of claims cost management for payers and the inefficiencies of post-payment claims administration.
- How managing multiple systems, technologies, and vendors can lead to waste.
- An example of how Zenith American Solutions improved claims management efficiency and effectiveness after implementing a comprehensive pre-payment solution.
- The importance of choosing a technology architecture that ensures accurate and prompt payment, either through a complete integration of claim services or a best-of-breed pre-payment solution.
- Why flexibility and technology customization are critical in a complex claims environment where one size doesn’t fit all payers.
1 Tikkanen, R., Melinda K. Abrams, M.K. U.S. Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes? Commonwealth Health Fund. https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019