The rising cost of healthcare system complexity, and what can be done about it

It is no secret that the US healthcare system is notoriously complex. The numerous product features and options offered by health plans are difficult to understand. Pricing transparency is non-existent. That complexity, in turn, has a detrimental impact on consumers’ access to care, quality of experience and health outcomes. Unfortunately, the problem is getting worse. Consumers are frustrated when trying to determine whether their providers are in the plan’s network, why they got an expensive bill for a routine service they expected to be covered by insurance, or how to decipher unfamiliar language in their insurance policies. Federal and state regulation has ramped up as health benefits offerings have proliferated, further driving complexity, especially for providers and health plans. This paper explores the findings and implications of recent Accenture research that gauged consumers’ understanding of the healthcare system and their ability to navigate it to meet their needs. It also proposes ways to address the complexity of the healthcare system to ease the burden on consumers, payers and providers alike.