Theaverage physician practice updates information for 20 health plancontracts, and large practices may work with more than 30 healthplans. (Image: Shutterstock)

Managing staff directories costs physician practices in the U.S.$2.76 billion each year, a new survey finds. The time and moneyspent on the task comes to an average of $999 per practice permonth—the equivalent of one full-time staff day per week.

The survey of 1,240 physician practices wasconducted by CAQH, a nonprofit stakeholders group that promotesstreamlining of health care business processes. The grouprecommends a single platform for updating and managing providerdirectories, saying that physician practices would save more than$1 billion a year if a uniform system was put in place.

Related: Fixing health care starts with betteradministrative systems

"Our nation's fragmented approach to maintaining providerdirectories is not only a burden on physician practices, it may beundermining the accuracy of the data," said April Todd, senior vicepresident with CAQH. "Health plans rely on the informationproviders give them. If we minimize the requests that driveprovider burden, we can improve the accuracy of the data."

An administrative jungle

The survey outlined a system that has a great deal of variationin how information is submitted and processed. The survey foundthat the average physician practice updates information for 20health plan contracts, and large practices may work with more than30 health plans. The study noted that some health plans have workedto reduce this administrative burden, but practices are stilldealing with multiple requests, formats, and schedules for thevarious plans with which they contract.

For example, a 2018 America Medical Association survey foundthat providers used a variety of means to provide directoryinformation, including by fax (38 percent); credentialing software(13 percent); email (13 percent); provider management andenrollment software (5 percent); and phone, mail and other methods(14 percent).

Adding to the problem are regulatory requirements that varybetween government programs. "CMS requires Medicare Advantage plansto contact providers quarterly. States require commercial andgovernment-funded plans to conduct outreach on a variety ofschedules, including some that exceed the federal requirements,"the report said. "According to Berkeley Research Group, 19 statesrequire provider directory updates at least on a monthly basis; 12require updates between quarterly and annually; and seven requiredirectories to be 'up to date' or updated in a timely manner."

Missing the mark on accuracy

Keeping information accurate and up to date is a majorchallenge, the study said. CMS research conducted by the Centersfor Medicare and Medicaid Services (CMS) found that as much as halfof the information contained in provider directories may beinaccurate. "Because members rely on directories to identify andcontact providers in their plan, inaccurate directories can presenta barrier to care and result in higher out of pocket costs," CAQHsaid in its release.

CAQH, which markets its own streamlined platform for updatingprovider information, said its research indicates that practicesusing one channel for maintaining provider directories spend nearly40 percent less per month than those that use multiple channels.The group estimates that if all practices used a similar approach,the average physician practice could save $4,746 annually.

"This is going to take an industry-wide solution," said Todd."If payers along all lines of business work together to reduce theburden on providers through a single streamlined approach, we canimprove the accuracy of directories for all consumers."

Read more: 

• Cost to create a medical bill? $99k per year perdoctor
• 4 recommendations for combating health care's highadministrative costs
• Health plan provider directories lose to Google onaccuracy