CAQH Press Releases | Affordable Quality Health Care Press | News

Streamlined, automated process delivers higher quality data, more efficiently

WASHINGTON, DC - 10/4/18

CAQH has launched CAQH ProView for Groups, simplifying the way data is shared between delegated provider groups and health plans. This first-of-its-kind functionality replaces the highly manual processes widely used today with an intuitive, efficient module within CAQH ProView.

WASHINGTON, DC - 10/1/18

For the third consecutive year, CAQH, an industry alliance working together to streamline the business of healthcare, has been named one of the “Best Places to Work” by Modern Healthcare.

Industry veteran will work with CAQH participating plans, providers and other stakeholders to advance the organization's mission of streamlining the business of healthcare

WASHINGTON, DC - 9/25/18

CAQH® announces Mark Pratt as the organization’s Senior Vice President of Public Affairs. In this role, Pratt will lead CAQH state and federal government relations, regulatory affairs and public policy efforts to advance the organization’s mission to transform business processes in healthcare.


HealthCare Administrative Solutions (HCAS), a non- profit organization of Massachusetts based health plans, has selected DirectAssure®, a CAQH Solution®, to improve the quality and timeliness of healthcare provider directories for its member health plans that operate throughout New England.

State agencies and health plans covering 44% of all Medicaid enrollees demonstrate commitment to automation, efficient processes through CORE Certification; remaining payers have an opportunity for savings, operational improvements

WASHINGTON, DC - 8/13/18

CAQH CORE® today announced that state agencies and health plans covering 44 percent of all Medicaid enrollees have achieved some level of CORE Certification. This compares to 78 percent for commercial health plans and 75 percent for Medicare Advantage plans. Medicaid agencies and health plans can save more than $4.8 billion annually by fully adopting CAQH CORE Operating Rules for electronic transactions as verified by certification.

In letter to authors of the Consensus Statement on Improving Prior Authorization, CAQH CORE highlights areas of agreement, opportunities to address burdens on healthcare providers, health plans and patients

WASHINGTON, DC - 7/26/18

The Board of CAQH CORE®, a collaboration of more than 130 public and private entities across the healthcare industry, today released an open letter to the authors of the Consensus Statement on Improving the Prior Authorization Process, which include the American Hospital Association (AHA), America’s Health Insurance Plans (AHIP), American Medical Association (AMA), American Pharmacists Association (APhA), Blue Cross Blue Shield Association (BCBSA) and Medical Group Management Association (MGMA). In the letter, the CAQH CORE Board endorses the statement and urges ongoing cooperation to reduce healthcare costs, ease administrative burdens and improve continuity of care and the patient experience.

HITRUST Certification validates CAQH commitment to meeting key healthcare regulations and protecting sensitive private healthcare information.

WASHINGTON, DC - 6/18/18

CAQH®, a nonprofit alliance focused on simplifying the business of healthcare, today announced that the stated portfolio of CAQH Solutions® has earned Certified status for information security by the Health Information Trust (HITRUST) Alliance.

Healthcare Providers Would Gain Greatest Share of Savings -- $9.5 Billion

WASHINGTON, DC - 6/14/18

The U.S. healthcare industry made a modest amount of progress in automating claims-related business processes, but a significant opportunity to save $11.1 billion annually remains, according to new data released today in the fifth annual CAQH Index®. The report shows increased use of some manual transactions – primarily via web portals – resulting in a reversal of gains made for some of those transactions in previous years and the increase in potential savings.

Provider Data Action Alliance makes recommendations to address pressing issue impacting providers, patients and health plans

WASHINGTON, DC - 5/30/18

A diverse cross-section of healthcare leaders today released recommendations to develop an efficient, sustainable system for accurate provider data. In its report, “An Industry Roadmap for Provider Data,” the Provider Data Action Alliance, a group convened by CAQH, concluded that broad industry collaboration is needed to improve provider data.

Industry Collaboration Required to Avoid Repeating Operational Challenges of Electronic Fee-for-Service Transactions

WASHINGTON, DC - 3/28/18

New research from CAQH CORE®, released today, analyzes operational challenges that may slow or add costs to the implementation of value-based payment. The research found that industry collaboration is needed to minimize variations and identified five operational opportunity areas that, if improved, would smooth implementation.