We’re paying more for paperwork than for care.
From 1975 to 2010, the number of doctors and other clinicians treating patients increased 150%. The number of people working in administrative jobs in health care increased by more than 3,000%.
Health care is the only industry where new technologies cause costs to increase rather than decrease. Every “improvement” just adds to the mess. Here’s why:
There’s no shared health record.
Every doctor, hospital, and insurer holds a piece of the puzzle, but they don’t share with each other, and certainly don’t share with you.
Everyone keeps adding new measures and systems.
- Health plans track 1,485 quality measures.
- Hospitals use four different systems with 160,000 codes.
- The average doctor reports on 57 different scorecards.
But if everything is important, then nothing is. And chasing so many quality metrics adds to cost, without actually improving quality.
Routine work isn’t automated.
How many people, fax machines, and weeks of work can it take to pay a claim?
The technology to solve these issues already exists. The problem is getting everyone on the same page, agreeing to measure the same way, and automating the easy stuff.
We could save $300 billion in administrative costs without affecting a single clinical decision.
Here’s how to fix it.
01
Digitize
It's 2026. This is ridiculous. Every American should have a real-time digital health record. We need a federal law that requires providers to share all patient data with each other and with patients. Records also need to transfer automatically when you change health plans, and tech companies must comply with privacy laws.
02
Simplify
We need to streamline all the laws, regulations, and norms for tracking care into a single national standard. Then we can all use the same scorecards for quality, patient satisfaction, provider credentialing and directories, payment structures, and benefit design (so people can easily compare plans).
03
Automate
Billing, claims settlement, prior authorization, provider directory updates, even routine questions from patients and providers – they should all be automated. What now takes weeks or months should take seconds. This is a perfect example of where AI can be used responsibly (with extensive human oversight) to solve real-world problems.
Progress toward legislation.
A bipartisan group of federal and state leaders has been pushing for greater healthcare data sharing for years. Here’s where we are so far: In California, different health care entities must share patient records with each other. The next step in California is to ensure that all customers have easy access to that data.
But this is a national issue, so Paul Markovich worked with Blue Shield of California to write a draft of the kind of legislation we need at the federal level in the Comprehensive Digital Health Records for All Americans Act.
Paul Markovich addresses the Commonwealth Club, December 2018
More info.
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If you just want to dig into other perspectives on this problem, check out these articles.