– Providers spend $2.76 billion each year on provider directory maintenance, a new survey by CAQH found.
– For individual practices, this intensive process costs $998.84 per month–the equivalent of one staff day per week. That is time and money that most providers can’t afford to waste.
– CAQH surveyed 1,240 physician practices last month and just released “TheHidden Causes of Inaccurate Provider Directories“– a new white paper that details the burdens the survey uncovered and what the industry can do to address them.
Inaccurate provider directories have plagued the healthcare industry for years–but a groundbreaking new study from CAQH has quantified, for the first time, exactly how much of a burden maintaining directories is for providers and how that is contributing to errors. The numbers are staggering. For example, physician practices across the US spend $2.7 billion every year just on verifying and updating directory information for plans. The average practice dedicates one staff day per week to the task.
The survey of 1,240 physician practices, conducted in September 2019, determined that directory maintenance costs practices nationwide $2.76 billion annually. Updating directory information costs each practice $998.84 on average every month, the equivalent of one staff day per week.
The Hidden Causes of Inaccurate Provider Directories
The burden associated with the directory maintenance 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. Although individual health plans have worked to minimize the burden on providers in their network, practices must still respond to multiple requests and submit information in varying formats and on different schedules for each plan. This taxes practice resources and can result in errors.
The Provider Burden
Studies of online directories for Medicare Advantage plans conducted by the Centers for Medicare and Medicaid Services (CMS) found that as much as half of the information contained in directories maybe inaccurate. Because members rely on directories to identify and contact providers in their plan, inaccurate directories can present a barrier to care and result in higher out of pocket costs.
In spite of 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 encounter coverage issues at least once a month due to inaccurate directories. To address this problem, 67% of physicians surveyed by the AMA expressed an interest in having their practice use just one interface to send and update information to payers.
Single Platform Approach: The Best Solution to Reduce Administrative Burden?
To determine whether a single platform would reduce administrative burdens, CAQH examined how providers submit similar information for credentialing, in which many practitioners use one channel to provide updates to all of the health plans with which they contract. CAQH determined that practices that use one channel for all plans spend 39.6% less per month than those who use multiple approaches. Assuming similar efficiencies, using a single channel to update directory information could save the average physician practice $4,746 annually. Nationwide, streamlining directory maintenance through a single platform could save physician practices at least $1.1 billion annually.
Impact of These Findings
“Our nation’s fragmented approach to maintaining provider directories is not only a burden on physician practices, it may be undermining the accuracy of the data,” said April Todd, CAQH Senior Vice President for CORE and Explorations. “Health plans rely on the information providers give them. If we minimize the requests that drive provider burden, we can improve the accuracy of the data.”
“This is going to take an industry-wide solution,” said Todd. “If payers along all lines of business work together to reduce the burden on providers through a single streamlined approach, we can improve the accuracy of directories for all consumers.”
For more information, read the white paper: “The Hidden Causes of Inaccurate Provider Directories”