Simplifying Administration of Health Insurance

The high administrative costs of the U.S. health insurance system have been a focus of discussion for decades. This paper reviews ways to define and classify administrative costs, both of insurers and of other participants in the system, and summarizes the fragmentary estimates of how large these costs are. It discusses current efforts to reduce administrative costs, many of which have focused on standardizing and simplifying transactions among insurers, providers, and employers. Finally, it considers how various reform proposals, whether or not directly targeted at administrative costs, might reduce—or add to—the complexity of the current system.