Accessibility Statement Skip Navigation
  • Why PRWeb
  • How It Works
  • Who Uses It
  • Pricing
  • Login
  • GDPR
  • Create a Free Account
Return to PRWeb homepage
  • News
  • Resources
  • Contact
When typing in this field, a list of search results will appear and be automatically updated as you type.

Searching for your content...

No results found. Please change your search terms and try again.
  • News in Focus
      • Browse News Releases

      • All News Releases
      • Multimedia Gallery

      • All Multimedia
      • All Photos
      • All Videos
  • Business & Money
      • Auto & Transportation

      • Aerospace, Defense
      • Air Freight
      • Airlines & Aviation
      • Automotive
      • Maritime & Shipbuilding
      • Railroads and Intermodal Transportation
      • Supply Chain/Logistics
      • Transportation, Trucking & Railroad
      • Travel
      • Trucking and Road Transportation
      • View All Auto & Transportation

      • Business Technology

      • Blockchain
      • Broadcast Tech
      • Computer & Electronics
      • Computer Hardware
      • Computer Software
      • Data Analytics
      • Electronic Commerce
      • Electronic Components
      • Electronic Design Automation
      • Financial Technology
      • High Tech Security
      • Internet Technology
      • Nanotechnology
      • Networks
      • Peripherals
      • Semiconductors
      • View All Business Technology

      • Entertain­ment & Media

      • Advertising
      • Art
      • Books
      • Entertainment
      • Film and Motion Picture
      • Magazines
      • Music
      • Publishing & Information Services
      • Radio & Podcast
      • Television
      • View All Entertain­ment & Media

      • Financial Services & Investing

      • Accounting News & Issues
      • Acquisitions, Mergers and Takeovers
      • Banking & Financial Services
      • Bankruptcy
      • Bond & Stock Ratings
      • Conference Call Announcements
      • Contracts
      • Cryptocurrency
      • Dividends
      • Earnings
      • Earnings Forecasts & Projections
      • Financing Agreements
      • Insurance
      • Investments Opinions
      • Joint Ventures
      • Mutual Funds
      • Private Placement
      • Real Estate
      • Restructuring & Recapitalization
      • Sales Reports
      • Shareholder Activism
      • Shareholder Meetings
      • Stock Offering
      • Stock Split
      • Venture Capital
      • View All Financial Services & Investing

      • General Business

      • Awards
      • Commercial Real Estate
      • Corporate Expansion
      • Earnings
      • Environmental, Social and Governance (ESG)
      • Human Resource & Workforce Management
      • Licensing
      • New Products & Services
      • Obituaries
      • Outsourcing Businesses
      • Overseas Real Estate (non-US)
      • Personnel Announcements
      • Real Estate Transactions
      • Residential Real Estate
      • Small Business Services
      • Socially Responsible Investing
      • Surveys, Polls and Research
      • Trade Show News
      • View All General Business

  • Science & Tech
      • Consumer Technology

      • Artificial Intelligence
      • Blockchain
      • Cloud Computing/Internet of Things
      • Computer Electronics
      • Computer Hardware
      • Computer Software
      • Consumer Electronics
      • Cryptocurrency
      • Data Analytics
      • Electronic Commerce
      • Electronic Gaming
      • Financial Technology
      • Mobile Entertainment
      • Multimedia & Internet
      • Peripherals
      • Social Media
      • STEM (Science, Tech, Engineering, Math)
      • Supply Chain/Logistics
      • Wireless Communications
      • View All Consumer Technology

      • Energy & Natural Resources

      • Alternative Energies
      • Chemical
      • Electrical Utilities
      • Gas
      • General Manufacturing
      • Mining
      • Mining & Metals
      • Oil & Energy
      • Oil and Gas Discoveries
      • Utilities
      • Water Utilities
      • View All Energy & Natural Resources

      • Environ­ment

      • Conservation & Recycling
      • Environmental Issues
      • Environmental Policy
      • Environmental Products & Services
      • Green Technology
      • Natural Disasters
      • View All Environ­ment

      • Heavy Industry & Manufacturing

      • Aerospace & Defense
      • Agriculture
      • Chemical
      • Construction & Building
      • General Manufacturing
      • HVAC (Heating, Ventilation and Air-Conditioning)
      • Machinery
      • Machine Tools, Metalworking and Metallurgy
      • Mining
      • Mining & Metals
      • Paper, Forest Products & Containers
      • Precious Metals
      • Textiles
      • Tobacco
      • View All Heavy Industry & Manufacturing

      • Telecomm­unications

      • Carriers and Services
      • Mobile Entertainment
      • Networks
      • Peripherals
      • Telecommunications Equipment
      • Telecommunications Industry
      • VoIP (Voice over Internet Protocol)
      • Wireless Communications
      • View All Telecomm­unications

  • Lifestyle & Health
      • Consumer Products & Retail

      • Animals & Pets
      • Beers, Wines and Spirits
      • Beverages
      • Bridal Services
      • Cannabis
      • Cosmetics and Personal Care
      • Fashion
      • Food & Beverages
      • Furniture and Furnishings
      • Home Improvement
      • Household, Consumer & Cosmetics
      • Household Products
      • Jewelry
      • Non-Alcoholic Beverages
      • Office Products
      • Organic Food
      • Product Recalls
      • Restaurants
      • Retail
      • Supermarkets
      • Toys
      • View All Consumer Products & Retail

      • Entertain­ment & Media

      • Advertising
      • Art
      • Books
      • Entertainment
      • Film and Motion Picture
      • Magazines
      • Music
      • Publishing & Information Services
      • Radio & Podcast
      • Television
      • View All Entertain­ment & Media

      • Health

      • Biometrics
      • Biotechnology
      • Clinical Trials & Medical Discoveries
      • Dentistry
      • FDA Approval
      • Fitness/Wellness
      • Health Care & Hospitals
      • Health Insurance
      • Infection Control
      • International Medical Approval
      • Medical Equipment
      • Medical Pharmaceuticals
      • Mental Health
      • Pharmaceuticals
      • Supplementary Medicine
      • View All Health

      • Sports

      • General Sports
      • Outdoors, Camping & Hiking
      • Sporting Events
      • Sports Equipment & Accessories
      • View All Sports

      • Travel

      • Amusement Parks and Tourist Attractions
      • Gambling & Casinos
      • Hotels and Resorts
      • Leisure & Tourism
      • Outdoors, Camping & Hiking
      • Passenger Aviation
      • Travel Industry
      • View All Travel

  • Policy & Public Interest
      • Policy & Public Interest

      • Advocacy Group Opinion
      • Animal Welfare
      • Congressional & Presidential Campaigns
      • Corporate Social Responsibility
      • Domestic Policy
      • Economic News, Trends, Analysis
      • Education
      • Environmental
      • European Government
      • FDA Approval
      • Federal and State Legislation
      • Federal Executive Branch & Agency
      • Foreign Policy & International Affairs
      • Homeland Security
      • Labor & Union
      • Legal Issues
      • Natural Disasters
      • Not For Profit
      • Patent Law
      • Public Safety
      • Trade Policy
      • U.S. State Policy
      • View All Policy & Public Interest

  • People & Culture
      • People & Culture

      • Aboriginal, First Nations & Native American
      • African American
      • Asian American
      • Children
      • Diversity, Equity & Inclusion
      • Hispanic
      • Lesbian, Gay & Bisexual
      • Men's Interest
      • People with Disabilities
      • Religion
      • Senior Citizens
      • Veterans
      • Women
      • View All People & Culture

  • Hamburger menu
  • Cision PRWeb provides efficient communication tools to continuously engage with target audiences across multiple online channels
  • Create a Free Account
    • ALL CONTACT INFO
    • Contact Us


      11AM ET Sunday – 8PM ET Friday

  • Send a Release
  • Sign up
  • Log in
  • Resources
  • RSS
  • GDPR
  • News in Focus
    • Browse All News
    • Multimedia Gallery
  • Business & Money
    • Auto & Transportation
    • Business Technology
    • Entertain­ment & Media
    • Financial Services & Investing
    • General Business
  • Science & Tech
    • Consumer Technology
    • Energy & Natural Resources
    • Environ­ment
    • Heavy Industry & Manufacturing
    • Telecomm­unications
  • Lifestyle & Health
    • Consumer Products & Retail
    • Entertain­ment & Media
    • Health
    • Sports
    • Travel
  • Policy & Public Interest
  • People & Culture
    • People & Culture
  • Send a Release
  • Sign up
  • Log in
  • Resources
  • RSS
  • GDPR
  • Send a Release
  • Sign up
  • Log in
  • Resources
  • RSS
  • GDPR
  • Send a Release
  • Sign up
  • Log in
  • Resources
  • RSS
  • GDPR

Tackling Rampant Waste in Healthcare - A Guide for Healthcare Providers in the New Consumer-Driven Marketplace: Industry Analysis by Loyale Healthcare

One out of every four dollars spent on healthcare in the U.S. is wasted, according to research published this week by the Journal of the American Medical Association. Interventions to reduce administrative complexity and improve patients' financial experiences have the potential to generate billions in revenue


News provided by

Loyale Healthcare

Oct 10, 2019, 06:10 ET

Share this article

Share toX

Share this article

Share toX

Hundreds of billions of dollars spent on healthcare in the U.S. are wasted annually
Hundreds of billions of dollars spent on healthcare in the U.S. are wasted annually

LAFAYETTE, Calif., Oct. 10, 2019 /PRNewswire-PRWeb/ -- In startling new research published just this week by the Journal of the American Medical Association (JAMA), researchers from Humana, Inc. and the University of Pittsburgh School of Medicine estimated that the cost of waste in the U.S. Healthcare system amounts to between $760 billion and $935 billion in healthcare spending annually. That's approximately one in four of every dollar spent on healthcare in America.

The study references findings from 54 unique peer-reviewed publications, government-based reports and other sources. It focuses on six sources of inefficiency in the system and identifies "opportunities to address those inefficiencies, and underscore several key solutions to make health care more affordable for all Americans". The six sources of inefficiency, or "waste domains", identified and the estimated annual savings achievable through intervention according to the researchers are:

By embracing more retail-like operating practices, health systems and hospitals can reduce costs, improve employee morale, ease administrative burdens and deliver better patient experiences - Kevin Fleming, CEO, Loyale Healthcare

Post this

1. Failure of Care Delivery - $44.4 - $93.3 billion in savings through intervention
2. Failure of Care Coordination - $29.6 - $38.2 billion
3. Overtreatment or low-value care - $12.8 - $28.6 billion
4. Pricing Failure - $81.4 - $91.2 billion
5. Fraud and Abuse - $22.8 - $30.8 billion
6. Administrative Complexity - Researchers found no studies that focused on interventions targeting administrative complexity, however this category represents the greatest source of waste.

Of these six, two of the waste domains listed in the research can be directly impacted through interventions affecting patients' financial experiences - Pricing Failure and Administrative Complexity. Together, these two categories represent potential savings of between $329.4 - $339.2 billion annually when using the $248 billion in waste attributable to administrative complexity calculated earlier this year in a report from the Center for American Progress.

The JAMA research report calls out a number of inefficiencies and suggests interventions that include more seamless data interoperability and improved pricing transparency, particularly as it affects the price of prescription medication. But price transparency has a much broader relevance when considering the industry as a whole and the patients' increasingly prominent role as a revenue source to the healthcare industry.

Pricing Failure and Healthcare Price Transparency - The Big Picture

Many of healthcare's inefficiencies stem from the industry's freedom from market pressures faced by the rest of the American economy. For decades, the financial dynamic in healthcare was driven by the relationship between healthcare providers and the health insurance plan companies who covered their patients.

For most of that time, patients didn't care much about how much their care cost. Their health plan premiums and copays were low, and the plan covered the rest. Then, starting in the early 2000s, high deductible health plans were introduced by employers who could no longer afford to absorb outsized annual increases of their employees' coverage. These increases were due in large part to government policy and U.S. lifestyle changes, as described in in-depth analysis from online publication The Balance.

Since then, costs have continued to soar, affecting not just out-of-pocket expenses associated with higher deductibles and copays, but higher patient premiums too. Recent research from the Kaiser Family Foundation reported that average annual family premiums for healthcare topped $20,000 in 2018 for the first time. That's $20,000 per year, per family - plus their deductibles and copays.

American healthcare consumers are struggling as a result. In a report published this summer by Kaiser Family Foundation, the cost of care "ranks at the top of things Americans worry about. It also plays a significant role in the patient experience from decisions on whether or not to get care to the impact of medical bills after receiving care." But patients aren't the only ones struggling. Providers, too, are feeling the adverse effects of today's dysfunctional patient payment system as they deal with mounting patient bad debt.

This challenging financial scenario is driving a number of fundamental changes to the way patients perceive and select healthcare providers. More than ever before, patients are beginning to research their healthcare options, with a decided preference for those who present reliable cost estimates and convenient access to care. This is particularly true among younger consumers as reported in Loyale Healthcare analysis published earlier in the year.

Today's environment has also opened the door to innovative new competitors and care delivery models. Haven Healthcare, the joint healthcare venture formed by Amazon, Berkshire Hathaway and JP Morgan Chase, Walmart Health, CVS Health and Walgreens Health are examples. All of these ventures bring a proven, customer-centric perspective to the business of delivering care, and the assurance that it will be easier to access and - most importantly - more affordable.

Finally, Patient Consumerism Has Arrived

When high deductible plans were introduced, it was believed that patients' higher out-of-pocket expenses would motivate them to be more selective about when and where to get care. What was missing in this calculation was the fact that patients didn't have access to the price and quality information they needed to make informed decisions. Instead, they kept doing what they had always done, with one glaring exception - according to a patient survey conducted by westhealth institute and NORC at the University of Chicago in 2018, nearly 40% of respondents reported skipping a recommended test or treatment and 44% said they didn't go to a doctor when they were sick or injured.

More recently, however, several important new trends have been noted. A report published by TransUnion Healthcare found that 75% of patients research costs on provider and payer websites and other sources, and that the information they find impacts their decisions. 62% said that knowing out-of-pocket expenses in advance impacts the likelihood that they'll seek care, and 49% said that clear information on healthcare out-of-pocket expenses impacts their decision to use a healthcare provider.

Patients are making it clear. After ten years of waiting for the healthcare industry to voluntarily join the market, the market is forcing healthcare to join in. Price transparency, once considered too difficult and variable to estimate, is fast becoming a business imperative for healthcare providers who intend to remain relevant in what PwC describes as The New Health Economy. Topping off this market pressure are regulators and legislators who are responding to the concerns of angry constituents who can no longer endure the high cost of care, as explored in a recent Loyale article.

As participants in the consumer economy, healthcare providers that empower patients with price transparency are experiencing some surprising, positive outcomes. By presenting reliable estimates upfront, they're attracting more patients. Even more importantly, because the conversation about price occurs early in the care interaction, the hospital and patient are able to collaborate on strategies to ensure a favorable outcome for both parties.

Additionally, the platform that enables improved transparency and more consumer-friendly financial engagement also reduces the second "waste domain" defined in the above-mentioned JAMA research report, administrative complexity.

Patient Financial Engagement to Reduce Administrative Costs and Complexity

After nearly thirty years of developing digital tools to influence positive consumer payment behavior in their interactions with complex corporate ecosystems, Loyale Healthcare developed Loyale Patient Financial Manager™, the healthcare industry's most widely deployed end-to-end patient financial engagement platform. With it, healthcare providers are delivering the information their patients need to make important care decisions and to partner with their provider to find the surest path to care and payment.

For providers, Loyale's technology is completely interoperable with all major technology systems currently in use as well as several emerging technologies. Further, using sophisticated data analytics, the platform automatically segments patient populations. This segmentation drives personalized communications at the right times over the right channel (email, text, chat, phone, paper), and collection workflows to improve the probability of payment.

Lastly, because the system tracks elements of the care-and-payment experience from beginning to end, its data-gathering and analysis capabilities are unparalleled, giving providers better visibility into their patients' experiences and payment behavior than most have ever had. With better intelligence, providers can then plan to continually improve their care and operating efficiencies.

The Convergence of Waste Reduction and Consumerization

Working with healthcare providers across the country, Loyale is proving that by embracing more retail-like operating practices, health systems and hospitals can reduce costs, improve employee morale, ease administrative burdens and deliver better patient experiences.
The transition to a more market-based approach is not an easy one, culturally or operationally, but with the right tools and partner it can be achieved more quickly than most providers imagine. And - by combining improved efficiency with better collections and a more competitive consumer profile, the dividends are compelling, even game changing. We at Loyale are privileged to work with healthcare's game changers to help accelerate the transition.

Kevin Fleming is the CEO of Loyale Healthcare

Loyale Patient Financial Manager™ is a comprehensive patient financial engagement technology platform leveraging a suite of configurable solution components including predictive analytics, intelligent workflows, multiple patient financing vehicles, communications, payments, digital front doors and other key capabilities.

Loyale Healthcare is committed to a mission of turning patient responsibility into lasting loyalty for its healthcare provider customers. Based in Lafayette, California, Loyale and its leadership team bring 27 years of expertise delivering leading financial engagement solutions for complex business environments. Loyale currently serves approximately 12,000 healthcare providers across 48 states. Loyale recently announced an Enterprise level strategic partnership with Parallon including deployment of its industry leading technology to all HCA hospitals and Physician Groups.

SOURCE Loyale Healthcare

Related Links

https://www.loyale.us

Modal title

Contact PRWeb

  • 11AM ET Sunday – 8PM ET Friday
  • Contact Us

About PRWeb

  • About PRWeb
  • Partners
  • Partnership Programs
  • Editorial Guidelines
  • Resources

Why PRWeb

  • Why PRWeb
  • How It Works
  • Who Uses It
  • Pricing

Accounts

  • Create a Free Account
  • Log in
  • Contact Us

Do not sell or share my personal information:

  • Submit via [email protected] 
  • Call Privacy toll-free: 877-297-8921

Contact Cision

Products

About

My Services
  • All News Releases
  • Online Member Center
  • ProfNet
Cision Distribution Helpline
888-776-0942
  • Legal
  • Site Map
  • RSS
  • Cookie Settings
Copyright © 2025 Cision US Inc.