Inaccurate Supplier Directories Cost Doctors’ Offices $ 2.76 Billion Per Year


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Report: Maintaining Supplier Directories Costs Physician Practices $ 2.76 Billion Per Year

– Suppliers spend $ 2.76 billion annually on maintaining supplier directories, according to a new survey from CAQH.

– For individual practices, this intensive process costs $ 998.84 per month, or the equivalent of one day’s work per week. This is time and money that most vendors cannot afford to waste.

– CAQH surveyed 1,240 doctor’s offices last month and just released “Hidden Causes of Inaccurate Supplier Directories” – a new white paper that details the burdens uncovered by the investigation and what the industry can do about them remedy.

Inaccurate vendor directories have plagued the healthcare industry for years, but a groundbreaking new study from CAQH quantified, for the first time, just how burdensome directory management is on vendors and how it contributes to errors. The numbers are staggering. For example, medical offices in the United States spend $ 2.7 billion annually just to check and update plan directory information. Average practice devotes one staff day per week to the task.

The survey of 1,240 physician offices, conducted in September 2019, found that maintaining directories nationally costs offices $ 2.76 billion per year. Updating directory information costs each firm on average $ 998.84 each month, or the equivalent of one day’s work per week.

The hidden causes of inaccurate supplier directories

The burden associated with maintaining the directory is due, in part, to the fact that average medical practice updates information for 20 health plan contracts, according to the survey. Large practices may have more than 30 health plan contracts. While individual health plans have strived to minimize the burden on providers in their network, practices still have to respond to multiple requests and submit information in different formats and on different schedules for each plan. This tax wastes resources and can lead to errors.

The supplier’s burden

Studies of online directories for Medicare Advantage plans conducted by the Centers for Medicare and Medicaid Services (CMS) found that up to half of the information in directories may be inaccurate. Because members rely on directories to identify and contact their plan providers, inaccurate directories can be a barrier to care and result in higher out-of-pocket costs.

Despite these challenges, providers see the importance of accurate directories. In a survey released by the American Medical Association (AMA) in January 2018, 52% of physicians said their patients had coverage issues at least once a month due to inaccurate directories. To address this issue, 67% of physicians surveyed by WADA expressed interest in their practice using a single interface to send and update information to payers.

Single platform approach: the best solution to reduce the administrative burden?

To determine whether a single platform would reduce administrative burdens, CAQH examined how providers submit similar information for accreditation, in which many practitioners use a single channel to deliver updates of all health plans. with which they contract. CAQH has determined that practices that use one channel for all plans spend 39.6% less per month than those that use multiple approaches. Assuming similar efficiencies, using a single channel to update directory information could save the average physician’s office $ 4,746 per year. Nationally, streamlining directory maintenance through a single platform could save medical practices at least $ 1.1 billion per year.

Impact of these findings

“Our country’s fragmented approach to managing vendor directories is not only a burden on medical practices, it can hamper data accuracy,” said April Todd, CAQH senior vice president for CORE and Explorations. “Health plans are based on the information providers give them. If we minimize the demands placed on the supplier, we can improve the accuracy of the data. “

“It’s going to require an industry-wide solution,” Todd said. “If payers across all industries work together to reduce provider burden with a single, streamlined approach, we can improve directory accuracy for all consumers. “

For more information, read the white paper: “Hidden Causes of Inaccurate Supplier Directories”

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