Staffing Shortages, Hybrid Work, Cyber Threats and AI Drive a 50% YOY Increase in Healthcare Administration Costs and Complexities

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 Despite Avoiding $193 Billion in Costs Annually Through Automation, Escalating Challenges in Workforce and Data Security Fuel Rising Expenditures

WASHINGTON, Jan. 30, 2024 /PRNewswire/ — CAQH today released its eleventh annual Index report measuring the progress healthcare providers and health plans have made automating electronic business processes. The 2023 CAQH Index found that, while adoption of automated workflows increased for the majority of processes, staffing shortages, security challenges and increased time required to conduct transactions contributed to higher spending – 50% for medical and 18% for dental – on transactions tracked by the report.

“The Index has identified tremendous savings opportunities. Of those, about 90% directly benefit healthcare providers,” said Sarah Ahmad, Chief Executive Officer at CAQH. “At a time when physician burnout is reaching crisis levels, the industry needs to work together to reduce administrative inefficiency, freeing providers to spend more time with patients and, ultimately, impacting the quality of care. We look forward to working with plans, providers and other stakeholders to drive these improvements forward.”

Every year, the CAQH Index tracks automation, spending and savings opportunities for administrative transactions related to verifying insurance coverage and cost-sharing, obtaining authorization for care, submitting claims and supplemental information, and sending and receiving payments. The report categorizes transactions by whether they are fully automated, partially electronic, or manual.

The latest report found that, of the roughly $400 billion estimated cost of administrative complexity in our healthcare system, nine transactions covered by the Index account for $89 billion, or 22%, of the total. Although reducing these costs will be complicated by staffing shortages, cybercrime and other factors, the medical and dental industries still can save a combined $18.3 billion annually through additional automation and process improvements.

“Provider time spent on administrative processes increased by 14% on average last year, costing the American healthcare system roughly $21 billion,” said Erin Weber, Chief Policy and Research Officer at CAQH. “With the data and technologies available to us today, we have the power to transform the way we conduct the business of healthcare. However, as an industry, we must align around consistent processes that enable providers to minimize the time spent learning new workflows. This is particularly important given the current labor shortage.”

To read the full report, click here, or to learn more, register for our webinar discussing the findings on February 6 at 2pm EST.

About CAQH
CAQH is a leading organization focused on aligning the healthcare ecosystem around essential solutions, creating a more connected and less costly experience for all. For more than 20 years, CAQH has partnered with millions of providers, thousands of health plans, state Medicaid agencies and leading healthcare stakeholders who leverage the organization’s solutions, operating rules and insights to connect and exchange data every day as a part of the business of healthcare. Learn more at CAQH.org.

SOURCE CAQH

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