Lessons The U.S. Healthcare System Can Learn From The Banking Industry

Originally published in Forbes.

Many Americans have been breaking their silence in recent months about their experiences with healthcare. Across the nation, people have shared their stories about how they had turned to healthcare in their moments of greatest vulnerability but instead found themselves fighting for coverage, battling denials and navigating bureaucracy rather than receiving the care they or their loved ones needed.

In my view, these patient stories laid bare a healthcare system that had betrayed its fundamental promise to put patients first. We need to look beyond healthcare's endless debates for answers. Banking, another highly regulated industry that once seemed too big to change, provides a powerful example.

A $5 Trillion Industry Struggling With Key Functions

I believe healthcare, despite managing nearly $5 trillion in annual spending, operates similarly to how banking did 50 years ago. As the president of a company that provides direct healthcare and financial services solutions, I've seen how the industry struggles to perform some of its most basic tasks: moving money efficiently and sharing critical patient information. Many providers routinely wait at least a month or more for payments. Sharing patient records with other providers is often challenging. Administrative costs consume approximately 25% of healthcare spending—money lost to payment delays, redundant processes and fragmented systems.

The cost of this failure is experienced in both human and financial terms. A lack of interoperability can make it difficult for providers to get a patient's complete medical record. This means emergency rooms, for example, might inadvertently treat patients without knowing crucial information about existing conditions, allergies or medications. Doctors order expensive tests that were just performed across town. Meanwhile, many hospitals and medical practices are struggling with working capital, rising costs and negative operating margins.

What Banking Got Right

Banking has repeatedly turned crises into opportunities for reinvention. From the Great Depression to the 2008 Great Recession, each crisis forced banking to evolve.

After the Depression, the Federal Deposit Insurance Corporation restored public confidence by guaranteeing deposits. This foundation of trust enabled the next step: In the 1970s, the Automated Clearing House system was established, which allowed for electronic payments. Today, a deposit in Maine now works like a deposit in Montana because of a uniform digital language.

In 2008, another financial crisis challenged system resiliency and strength. Once more, banking responded with comprehensive reforms that strengthened stability. Today, consumers can deposit checks with their phones, send money instantly to friends and manage investments from anywhere. Businesses process international payments in seconds rather than days. The essential bedrock supporting all these capabilities? A unified system that enables financial institutions to communicate with speed and security.

Healthcare's Parallel Challenge

Healthcare's struggles mirror some of banking's past problems and patterns. Similar to banking, I believe healthcare needs universal payment processing and information-sharing standards.

On the payment side, clearinghouses exist to process claims, but participation isn't universal. Providers still chase payments, manage denials and struggle with cash flow without mandatory standards. On the information side, the fragmentation runs deeper and has become exacerbated. While 96% of hospitals use certified electronic health records, many systems operate in isolation, making it difficult to share or access vital patient information beyond their walls.

A Path To Adoption

History offers a path forward. The Civil Rights Act demonstrated the power of tying Medicare funding to non-discrimination compliance. We can apply this same strategy: Make participation in Medicare, Medicaid and other federal programs contingent on adopting universal standards for payments and data sharing.

But regulation alone isn’t sufficient. I believe banking’s transformation succeeded because regulatory frameworks worked alongside market forces. While new rules established the framework, it was customers who pushed banks to reimagine their services and experiences. Financial institutions discovered they could deliver more value by embracing digital innovation. Those that adapted thrived; those that resisted lost market share.

Implementing these changes could unlock significant value across healthcare. From my perspective, universal healthcare standards could help reduce administrative overhead and improve provider cash flow. Streamlining payments could help stabilize struggling practices and hospitals. Interoperable medical records could help eliminate costly redundant tests and procedures while enabling data-driven insights that could fundamentally improve patient care.

But these changes will only happen when patients, employers and policymakers demand more from healthcare. Many financial institutions shifted from traditional "bankers’ hours" to 24/7 access because customers insisted on convenience and accessibility. Similarly, healthcare will only change when stakeholders advocate for updates to the current system.

How Leaders Can Help

There are several actions employers and health plans can take to help influence needed changes. First, health plans can explore strategies to pay providers faster. Employers can also partner with their brokers and third-party administrators to advocate for network changes where high-performing providers are paid faster in exchange for lower rates and where there are no copayments or coinsurance for the member, which could limit bad debt.

In addition, employers could advocate for state health plan risk-based capital and reserve requirements to be linked to payment liquidity. In other words, these requirements could be eased if there are improved payment systems for providers. This could help with the speed and efficiency of provider payments. The goal is to create a more efficient payment and delivery system and ultimately save costs and ease administrative burdens.

The Future Of Healthcare: No Longer Business As Usual

The healthcare industry can continue with incremental adjustments, watching as inefficiency drags down one of America's largest industries, or we can use this moment to drive meaningful reform. Banking's greatest lesson isn't about technology or regulations—it’s about what happens when an industry is forced to confront its fundamental failures. Banks didn't change because they wanted to; they changed because a crisis left no alternative. Laws demanded it, markets required it and consumers wouldn't accept anything less.

I believe healthcare stands at this crossroads today. We can continue treating symptoms or we can address the underlying disease: a system designed around institutions rather than patients. Every delayed payment to a healthcare provider, every redundant test ordered and every hour spent fighting bureaucracy instead of treating patients are more than inefficiencies. They're opportunities for companies willing to build a better system.