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American hospitals spend nearly $2 on administrative overhead for every $1 allocated to direct patient care, according to a number cited by Trilliant Health.
The Centers for Medicare & Medicaid Services (CMS) is launching a new value-based care program, the LEAD model, in January 2027.
PIM Holdings believes it can adjudicate and pay approximately 70% of routine healthcare claims in near real-time.
Large insurance companies like UnitedHealth Group, Cigna, and Aetna earn billions of dollars in interest payments by delaying claim payments to providers.
PIM Holdings proposes to eliminate prior authorizations as they currently exist by having physicians attest to medical necessity in real-time.
The average cost to process a healthcare claim today is between $10 and $15.
PIM Holdings aims to reduce the cost of processing a healthcare claim to $1.
Administrative overhead accounts for approximately $1 trillion, or 20%, of the nearly $5 trillion U.S. healthcare industry.
PIM Holdings expects to begin participating in open enrollment in 2027.
When IVX Health was founded in 2013, it experienced growth of 20% to 30% per quarter.
In its early days, IVX Health typically had to wait 30 to 40 days to receive reimbursement from payers for drugs it had purchased.
The U.S. healthcare industry is estimated to be a nearly $5 trillion business.