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May 22, 2024

Why U.S. policy needs to focus on pruning the healthcare transaction thicket

Healthcare Financial Management Association
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Summary
The article by Jeff and Trevor Goldsmith addresses the complexities and inefficiencies of the U.S. healthcare transaction system, emphasizing the need for reform. The Change Healthcare cyberattack highlights the vulnerabilities in the healthcare payment infrastructure, which handles $5 trillion annually and involves numerous transactions, many of which are non-essential and burdensome. These transactions, often requiring manual input, contribute to high administrative costs and physician burnout. The authors argue for reducing transaction volume by 50%, standardizing business rules, and simplifying payment processes, while acknowledging that overcoming entrenched interests and ensuring data security present significant challenges.

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