By NextBestFitHospital billing costs avoided
Provider-side administrative savings from one payer, one claim format, no prior authorization, and no patient collections. These savings are what make UHP rates viable; they are not subtracted again in the ledger.
Result
$69.5B
Per resident, per year
$204
÷ 341.1M people
Per household
$526
÷ 132.2M households
How it's calculated
| # | Step | Arithmetic | Value |
|---|---|---|---|
| 1 | 2024 revenue for this service Sources: CMS Office of the Actuary (2025) | $1.63T | |
| 2 | Billing & insurance-related cost share | 8.5% | |
| 3 | Share eliminated under one payer | 50% | |
| 4 | Annual cost avoided | $1,634.7B × 8.5% × 50% | $69.5B |
| 5 | Compare: revenue change under UHP | −$18.4B | |
| 6 | Net effect on providers' margin (revenue change + cost avoided) | −$18.4B + $69.5B | $51.1B |
Inputs used
| Input | Kind | Value |
|---|---|---|
| Billing & insurance-related cost share of hospital revenue | data, high confidence | 8.5% |
| Share of billing costs eliminated under one payer | estimate, medium confidence | 50% |
Trade-off: Billing staff lose jobs; providers' margins improve on average, but the distribution across hospitals and practices is uneven.