2013 U.S. Healthcare Efficiency Index Report: Industry Could Save Billions through Electronic Administrative Transactions

The CAQH U.S. Healthcare Efficiency Index® (Index) tracks and reports progress by the healthcare industry in its ongoing transition from manual to electronic administrative transactions.

In its Index Report on Electronic Administrative Transaction Adoption and Savings, the Index estimates the proportion of common administrative transactions conducted electronically in 2012 across the healthcare industry. The Index collected and analyzed more than 3 billion transactions from participating organizations for this purpose. These transactions include:

  • Claim Submission
  • Eligibility and Benefit Verification
  • Prior Authorization and Referral Certification
  • Claim Status Inquiries
  • Claim Payment
  • Claim Remittance Advice/Receiving and Posting Payments

The Index also estimates healthcare system savings and the remaining potential to reduce cost. Its savings estimates draw upon a cost analysis prepared for CAQH by Milliman, one of the world’s largest providers of actuarial and related products and services.

Findings show that the healthcare industry could save billions of dollars each year by continuing the shift from manual to electronic administrative transactions. A copy of the full report can be downloaded at http://www.caqh.org/pdf/2013Index.pdf.