The excessive complexity of healthcare administration and related tasks is a fairly recent development. Into the twentieth century, most patients paid their doctors directly, and a variety of factors limited widespread access to the relatively small number of extensive medical procedures that existed. With the scientific and medical advances of the mid-twentieth century, however, complicated medical procedures became more common and accessible. During the same period, more people began to carry medical and health insurance, which provided access to the money necessary for more extensive medical procedures. The combination of more expensive and risky treatments and the expansion of health insurance, along with increasing governmental regulation of the industry, generated significant administrative burdens on the delivery of medical care.
During the second half of the twentieth century, administrative concerns intensified for healthcare management groups. Medical care providers, especially larger organizations, began to rely heavily on more specialized administrative units to handle the increasingly complicated processes involved, and healthcare management expanded as a profession. By the beginning of the twenty-first century, healthcare management units handled the administrative duties for most healthcare providers.