Wider adoption of electronic transactions could save healthcare $9.4B, report says

Dive Brief:

  • Broader adoption of electronic business transactions could save U.S medical health plans and providers $9.4 billion a year, and dental plans and providers $1.9 billion, according to a new report from the Council for Affordable Quality Healthcare (CAQH).
  • Manual transactions cost providers and plans about $3 more per transaction than electronic, according to the report.
  • Providers on average spend eight — and as much as 30 — more minutes processing manual transactions, compared with electronic ones. Switching to full electronic transaction could save provider 1.1 million labor hours a week, CAQH stated.

Dive Insight:

While this report make the case for the fiscal benefits of electronic transactions, implementing an electronic work flow has seen some struggles in the provider setting. For example, increasing time spent on administrative tasks has been cited as a main cause of physician burnout. A study last year in the Annals of Internal Medicine found physicians spend roughly half of each workday on EHRs and administrative tasks, and just 27% of the day with their patients.
From a reform perspective, Dr. Ethan Basch, from the University of Carolina School of Medicine recently wrote many EHRs are complicating the shift to patient-centered care because they don’t allow physicians to collect and track patient-reported outcomes.

Still, CAQH notes moving to electronic transactions for prior authorizations can cut transaction time from 20 minutes to six minutes and lower costs to $1.89, from $7.50 per manual transaction.

While electronic transactions of claims status queries and legibility and benefits verifications are up more than 5% in the latest annual survey, many providers are still seeking manual verifications—to the tune of 72 million telephone calls in 2015, CAQH says.

To increase adoption of electronic transactions, the nonprofit recommends industry stakeholders share best practices, look for ways to reduce barriers to adoption and review existing standards, codes, operating rules and policies around business transactions.

Filed Under: Health IT Payer Hospital Administration Practice Management
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