2024 CAQH Index Foresees Major Opportunity for Health Care Savings

Should health care systems shift to more electronic, automated workflows, the industry has an opportunity to save upwards of $20 billion, according to the 2024 CAQH Index. Not only would these initiatives reduce waste and alleviate administrative burdens, but they could also bring down costs and allow for more concerted efforts to improve patient care and access.1

“Healthcare should be about patients, not paperwork,” Sarah Ahmad, CEO of CAQH, said in a statement.2 “The efficiencies gained through automation are not just numbers on a page; they represent time returned to patients, resources reallocated to care, and stress removed from already burdened systems.”

Manual workflows bog down administrative tasks in health care, automated and electronic systems could provide major relief for the health care system | image credit: Valeri Luzina - stock.adobe.com

This annual report, published since 2011, has been a valuable resource for federal agencies, researchers, providers, and industry leaders alike for considerations related to resource allocation, regulatory development, and all-around prioritization.1 In this year’s report, insights from patients and providers were highlighted to demonstrate the real-world effects of health care processes and transactions. More than 600 organizations throughout the dental and medical fields, as well as health plans, collaborated in this effort, representing 63% of insured individuals.

The report finds that administrative process greatly benefited from the adoption of fully electronic transactions, web portals, artificial intelligence (AI), and interactive voice response systems, among other forms of automation. The adoption of automated processes grew by an average of 2 percentage points, allowing the medical and dentistry industries to keep their administrative spending steady while contending with staff shortages, rising staff costs, and spending on administrative tasks. Furthermore, the volume of administrative transactions for the medical and dental industries increased by 13% and 20%, with the total electronic volume rising by 15% and 33%, respectively. As a result, more services are being provided to patients in a more efficient, streamlined manner.

In 2024, “Automation helped the industry avoid spending $222 billion on administrative tasks measured in the CAQH Index — a 15 percent increase from the previous year,” the report states. “Reducing manual tasks not only lowered costs and saved time but has the potential to boost staff satisfaction and ultimately patient care.”

When it came to electronic eligibility and benefit verification, automation adoption increased for both the medical and dental industries in 2024 (2% and 3%, respectively).

In total, the opportunity to save on costs for the medical industry rose to $18.4 billion, a 12% increase, and for the dental industry to $2.1 billion, constituting an 11% increase. Additionally, medical plans and providers saw a 5% increase in verifications, totaling 31.5 billion, and the dental industry saw a 24% increase, totaling 1.2 billion. When these checks are done electronically, rather than manually, the repots estimates that the medical industry could save upwards of $11.7 billion, a 27% increase, and the dental industry upwards of $580 million, a 7% increase.

Other highlights from the report included a 3% reduction in prior authorization volume—which remains one of the most time-consuming processes for providers and can greatly delay care. This result could be due to 25% of medical services no longer mandating precertification or prior authorization.

Electronic claims submissions also saw an increase for the medical and dental industries (1% and 16%, respectively) while manual submissions declined (6% and 14%). Spending related to claims submission, however, rose by 1% and 13% in the medical and dental industries. The report spotlights that, although these increases could be considered minor, administrative spending dedicated to claim submission makes up 23% and 21% of the medical and dental industries’ total spending for the year. Accurate claim submission remains a priority for providers in these fields, the report adds, due to “concern over the growing number of denials, as some plans have begun relying more on artificial intelligence (AI) to review submitted claims, which may result in delayed payments and multiple submissions to resolve as models and algorithms continue to become more refined.”

Ultimately, this report demonstrates the potential benefits to patients from more cost-effective and streamlined health care. The integration of automated systems and AI have shown to be useful for tackling the inefficiencies that lead to care delays and growing costs, while also enhancing data management and cybersecurity. Collaborative efforts between stakeholders remains imperative as these industries seek to build a better care network for their patients.

“By centering patients and providers in the conversation and fostering collaboration, this year’s Index not only identifies inefficiencies but offers actionable insights to transform the system,” Erin Weber, chief policy and research officer, CAQH, said in the statement.2 At present, routine administrative processes, including verifying insurance, contribute to $90 billion in annual spending. Should automated administrative workflows be more widely adopted, an estimated 70 minutes could be saved for each patient visit. “Healthcare doesn’t stand still and neither should we,” Weber said.

References

1. 2024 CAQH Index® Report. CAQH; 2025. Accessed February 18, 2025. https://www.caqh.org/hubfs/Index/2024%20Index%20Report/CAQH_IndexReport_2024_FINAL.pdf

2. New CAQH Index reveals $20B savings opportunity to cut waste, reduce costs, and improve patient access. CAQH. News release. February 11, 2025. Accessed February 18, 2025. https://www.caqh.org/news/new-caqh-index-reveals-20b-savings-opportunity-to-cut-waste-reduce-costs-and-improve-patient-access