We cover new solutions promising to swap manual workflows for automated operations on a weekly basis, but it’s rare that we get a chance to devote a full deep dive to the motivations driving the innovation:
- What workflows would see the biggest benefit from automation?
- What areas are healthcare orgs hoping to evolve in their operations?
- What teams stand to gain the most from automation?
Medallion’s 2024 State of Payer Enrollment and Credentialing Report gave us that chance, shedding light on those answers through a survey of nearly 350 healthcare executives.
Among the key findings from the report was the fact that 45% of respondents say their staffing levels are “inappropriately low,” yet 34% also feel the need to further cut headcount expenses.
- Those numbers are a recipe for burnout. 57% of enrollment and credentialing teams have experienced turnover in the past year, along with 36% of CNAs, 15% of NPs, and 11% of PAs.
One of the main reasons why enrollment and credentialing teams are feeling the pressure so acutely is because of the manual nature of their workflows.
- The payor enrollment process involves wrangling information from providers to fill out applications, staying on top of the evolving requirements of various health plans, communicating the enrollment status of every provider, and constantly following up with payors by email or fax.
- Those slow turnaround times directly impact the bottom line, with 46% of respondents reporting that unoptimized enrollment workflows cause them to miss out on revenue.
That isn’t even half the battle, with the credentialing process taking just as long to gather provider data, check qualifications, and complete primary source verifications.
- 84% of credentialing teams experience turnaround times of 15 days or more, which unfortunately isn’t too surprising considering that 30% manually verify credentials by visiting individual sites.
- Every day wasted waiting on credentialing is a day the provider isn’t seeing patients, and that missed reimbursement turns out to cost an average of $10k each day.
If those problems hit a little too close to home, automation is more than likely going to play a major role in the solution. An end-to-end platform like Medallion might be the right way to make that happen, and you can check out our coverage of the platform for a complete overview of how it can help fully automate payor contracting and enrollment, credentialing, and licensing.
The Takeaway
It’s no easy task to balance operational costs with a mission to provide high-quality care, but with the US healthcare industry spending over $800B every year on administrative tasks, it’s time to find a way to thread that needle. For a closer look at these issues and how Medallion might be able to help, make sure to head over to the full report.
