New Report Highlights Industry Progress Toward Full Automation

January 2019

The latest CAQH Index report shows that the healthcare industry continues to make progress toward automating business processes as the number of transactions increases. The sixth annual CAQH Index, released earlier this month, is the industry standard for tracking health plan and provider adoption of fully electronic administrative transactions. The report provides insights into how the business of healthcare is changing, calls for greater industry collaboration and identifies opportunities for cost savings. Major takeaways include:

The adoption of electronic transactions improved for most transactions.

Both the medical and dental industry saw substantial improvements in the adoption of electronic transactions, increasing as much as six percentage points by the medical industry and four percentage points by the dental industry.

The dental industry is progressing but continues to trail the medical industry.

While the dental industry made progress towards automation, it lags behind the medical industry. For at least three common transactions, the medical industry has achieved 80 percent or higher adoption of fully electronic processes. By comparison, the dental industry nears 80 percent adoption in only one – claim submissions.

The volume of transactions increased overall, while manual transactions declined in the medical industry.

The overall volume of transactions in the medical industry increased by 18 percent in the past year, while the volume of manual transactions declined by six percent for health plans and one percent for providers (see figure below). Transaction volume also increased for dental; however, these increases occurred for both electronic and manual transactions.

 

The savings opportunity declined for the first time since CAQH Index tracking began due to fewer manual administrative transactions.

The Index found that the combined industry savings opportunity declined by $700 million compared to the previous year due to fewer manual administrative transactions. Still, the latest CAQH Index estimates that the combined medical and dental industries could save $12.4 billion annually through greater automation. For both medical and dental industries, the greatest portion of these savings can be realized by providers – $8.5 billion for medical and $2 billion for dental providers.

To learn more about the findings, download the 2018 CAQH Index and on-demand webinar.

Interested in contributing data to the CAQH Index?

Sign up for more information about how health plans, providers, and vendors can impact ongoing research. In return for Index participation, data contributors receive customized reports that enable a deeper analysis of organizational performance alongside national results for benchmarking and cost savings opportunities.

 

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