We are surrounded by digital technology. It’s in our pockets, on our wrists, and touches almost every facet of our daily lives. Such a prolific use may lead us to believe that the world is more digitized than it actually is, or that the work of automation and its inherent benefits are already complete and realized.
The reality is that a colossal effort is still needed to bring administrative tasks online and implement the full potential of automation—especially in the healthcare industry. The upside to increasing automation would result in billions of dollars saved, costs lowered for consumers, and headaches avoided for administrative staff.
Smart Data Solutions is here to support any automation efforts, big or small because every step toward automating workflows counts toward process optimization. Below, we’ll discuss some statistics that will help light a fire under your desire to automate administrative processes.
Manual Workflows Leave Money On The Table
Data from the 2021 Council for Affordable Quality Healthcare (CAQH) Index found that, of the $391 billion spent on administrative complexity in the United States healthcare system, $42 billion, or 11%, is spent conducting administrative transactions tracked by the CAQH Index. Of this $42 billion, the industry can save $20 billion, or 48% of existing annual spending on administrative transactions, by transitioning to electronic transactions.
If it were a standalone market, $20 billion would be worth chasing but because this “loss” is simply unrealized savings, it’s overlooked. Similarly, automation is oftentimes put in place, but not utilized to its fullest extent. Team leads or project managers get the satisfaction of implementing automation and closing the book on the project without going deeper to see if greater savings exist.
While the industry has already avoided $166 billion annually by automating administrative transactions, money is left on the table because Payers and Providers are not fully utilizing the existing automation available to them.
Realize Cost Savings by Switching to Electronic Processes
It should come as no surprise that one of the main driving forces behind implementing automation is cost savings. The savings between manual and automated (fully or partially electronic) are massive and will only continue to grow. In 2019, automated transactions cost an average of $.61 versus $4 for manual transactions. In 2020 it was $.49 versus $4, and in 2021 the gap had widened to $.53 against $5.30.
Industry-wide the cost savings opportunity has increased 32% to a whopping $17.6B.
Here’s a snapshot of the industry-wide average savings per transaction: CAQH Infographic
- Eligibility and Benefit Verification: $15.09
- Prior Authorization: $10.99
- Claim Submission: $3.93
- Attachments: $4.02
- Coordination of Benefits: $1.11
- Claim Status Inquiry: $16.65
- Claim Payment: $2.37
- Remittance Advice: $4.06
This significant cost reduction is music to the ears of CEOs and CFOs looking to increase their margins. Not only that, but pursuing automation is simpler, less frustrating, and frees up human capital to be utilized on higher-value initiatives in an organization.
Gain Specialized Support to Optimize Administrative Workflows
Many staff and managers understand the potential savings and the efficiency gains of moving to partial or fully electronic medical transaction processing but are overwhelmed with where to start or how to properly implement a system that works for their company.
At SDS, we ensure the solutions we create work for your teams, and more importantly, your customers. We tailor process optimization strategies for nearly any situation so that you and your customers can maintain business-as-usual.
Our 80 in-house technologists are trained to tailor solutions and proprietary software. We specialize in machine learning and automation to deliver value at every stage in your process.
We know that SDS can help your organization on its automation journey. If you’re interested in learning more about how we set you on a path to lower costs, higher accuracy, and reduced overhead, contact us and we’ll work together to analyze your current processes and offer custom solutions to fit your business goals.