The cost of care delivery in the United States is almost universally acknowledged to be higher than it should be. The largest contributing factor, assert Duke University and Harvard Business School researchers in a newly published JAMA article, is the cost of collecting on bills.

Moving payments along an “unnecessarily complex, fragmented, and inefficient system of billing, coding, and claims negotiations in the US health care system,” argued University of Utah radiologist Dr. Vivian Lee and Brigham and Women’s Hospital senior scientist Bonnie Blanchfield in an accompanying editorial, “consumes an estimated $500 billion per year.” And, they noted, underreported true costs may be much higher.

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