Healthcare Data Gaps, Integration Drive Patient Costs

Healthcare patients and providers face rising costs and avoidable friction from failures in data, billing and industry organization. A survey of health system and health plan leaders found that while most consider accurate, timely provider data essential, only 12% rated their own data quality as excellent, contributing to inaccurate directories, stalled credentialing and disrupted referrals. Confusing or delayed medical bills also reduce payment rates and erode trust, particularly threatening rural and critical-access hospitals that operate on narrow margins. Separately, a patient whose uterine-polyp procedure was shifted from a lower-cost physician’s office to a health-system-owned surgery center saw her estimated cost double, illustrating concerns that vertical integration can steer patients toward more expensive care. Together, the reports point to administrative failures and consolidation as significant contributors to access problems, financial strain and higher healthcare costs.