1 in 3 Healthcare Dollars is Spent on Waste

The Problem

U.S. healthcare spending is on the rise.

Employers with self-funded healthcare plans for employees continue to see their costs rise year after year.
For some this means asking employees to contribute more than they ever have before to pay for healthcare insurance.
Contributing to the rising costs are issues such as:

  • Overtreatment
  • Fraud and abuse
  • Pricing failures
  • Duplication of services
  • Billing errors
  • Payment errors
  • Drug-seeking behavior

SmartLight was created because we saw the need for more independent, pro-active intervention in reducing unnecessary healthcare spend. Our goal is to deliver our insider expertise to self-insured employers to lower your healthcare costs."

Asha George

SmartLight Analytics CEO

The well-documented issue of rising healthcare costs:

  • Overuse of healthcare isn’t dominated by big-ticket procedures. Think more along the lines of pre-op lab work before a surgery or antibiotics prescribed for viruses. When low-cost services (less than $500) are used over and over, they add up to tremendous waste.
  • We all pay the price with increased premiums and health care costs. A Washington Health Alliance analysis recommends a critical eye toward eradicating overuse of low-cost services. Read more about the report here. U.S. spends far more on healthcare than other developed countries—and researchers say prices are still to blame. Read piece on fiercehealthcare.com
  • SHRM says employers will spend nearly $15,000 per employee on health benefits in 2019. Read their forecast

What’s the solution? There is significant evidence that implementing regularly scheduled ongoing review would be beneficial in reducing unnecessary healthcare claim payments, preventing waste and fraud and ultimately help employers manage their spend more efficiently.