Issue Briefs

The CAQH Explorations team periodically releases issue briefs outlining their work and research. Explore the issue briefs and reports below to learn about cost saving opportunities for the healthcare industry and more. 

 

 

provider-attribution

 

Communicating Attribution: Accessibility of Information to Support Value-based Payment Initiatives 

Published in November 2021, this issue brief outlines how patient attribution is exchanged and the challenges providers face related to attribution.

 

 

core-issue-brief-3

 

Healthcare Utilization During a Pandemic: How COVID-19 Impacted Administrative Transactions

COVID-19 affected every level of healthcare. This issue brief, published in Spring 2021, explores the impact the pandemic had on healthcare utilization and administrative transactions. 

 

Pharmacy Index

 

The 2019 CAQH Pharmacy Index

Published in 2020, the 2019 CAQH Pharmacy Service Index tracks the adoption of electronic transactions associated with verifying insurance coverage for pharmaceuticals and related services, obtaining  authorization for care, submitting a claim, and sending and receiving payments. 

 

credentialing-all-for-one

 

Credentialing - All for One

Many health plans and providers use a multiplicity of platforms to communicate with one another. This report explores the fragmented credentialing system, the opportunities for cost savings, and a better credentialing process for providers. 

 

FHIR Issue Brief

 

Engaging with HL7 FHIR: Health Plan Baseline Readiness and Challenges

In the Spring of 2020, the Centers for Medicare & Medicaid (CMS) released Final Rules supporting industry interoperability and patient information access. This issue brief explores medical plans' readiness and barriers to HL7 FHIR implementation. 

 

hidden-causes-provider-directories

 

The Hidden Causes of Inaccurate Provider Directories

A CAQH survey of 1,240 physician practices, conducted in September 2019, determined that directory maintenance costs practices nationwide $2.76 billion annually. Read the whitepaper to learn about this problem and how health plans and providers can work together to decrease the burden of directory updates.

CAQH Program