Maintaining provider directories costs US medical practices $2.76 billion a year

WASHINGTON, November 13, 2019 /PRNewswire/ — CAQH® today released the results of a survey of vendors across the United States that revealed the administrative burden associated with maintaining vendor directories. The survey of 1,240 medical practices, conducted in September 2019determined that directory maintenance costs are nationwide $2.76 billion annually. Updating directory information costs each practice $998.84 on average each month, the equivalent of one working day per week.

“Our country’s fragmented approach to maintaining provider directories is not only a burden on physicians, it can also impair data accuracy,” said April ToddCAQH Senior Vice President for CORE and Explorations. “Health plans depend on the information providers give them. If we minimize the demands on providers’ burden, we can improve data accuracy.”

The burden associated with maintaining the directory is due, in part, to the fact that the average physician 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 worked 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 timelines for each plan. This strains practice resources and can lead to errors.

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. Since members rely on directories to identify and contact providers for their plan, inaccurate directories can present a barrier to care and result in higher additional charges.

Despite these challenges, providers see the importance of accurate directories. In a survey published 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 the AMA expressed interest in having their practices use a single interface to send and update information to payers.

To determine whether a single platform would reduce administrative burdens, CAQH examined how providers submit similar information for accreditation, in which many practitioners use one channel to provide updates to all health with which they contract. The CAQH 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 medical practice $4,746 annually. Nationwide, streamlining directory maintenance through a single platform could at least save medical practices $1.1 billion annually.

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

Read the white paper: “Hidden Causes of Inaccurate Supplier Directories”

About the CAQH
CAQH is the leader in creating initiatives to streamline the healthcare industry. Through collaboration and innovation, CAQH accelerates the transformation of business processes, bringing value to providers, patients and health plans. To visit and follow us on Twitter: @caqh.


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