Healthcare relying more on electronic transactions, but inefficiencies persist, study says

The medical industry has seen an increase in electronic transactions this year; however, billions in savings could still be realized by switching from manual to electronic transactions, according to a report by nonprofit organization CAQH.

Four things to know:

1. For its sixth annual report, CAQH benchmarked how healthcare is progressing toward reducing administrative complexity. The study tracked adoption of HIPAA-required and other electronic transactions between healthcare providers and health plans, such as insurance verification, preauthorization and claim submission. CAQH also estimated the annual volume and cost of these transactions.

2. CAQH recorded "substantial increases" in several electronic transactions within the medical industry in the past year, according to the report. For example, the industry's adoption of electronic eligibility and benefit verification grew, as did its electronic coordination of benefits.

3. While transactions increased 18 percent overall in the past year, the volume of manual transactions fell 6 percent for health plans and 1 percent for providers. At the same time, the medical industry shaved $1.3 billion from its savings opportunity that lies in switching to electronic transactions. Potential savings now totals $9.8 billion.

4. "Overall, these findings are a positive sign that the healthcare industry is continuing to make progress in its transition from manual to electronic transactions," according to the report. "However, the 2018 CAQH Index estimates that the combined medical and dental industries could save an additional $12.4 billion annually with full adoption of electronic administrative transaction."

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