Progress tracking tops list of administrative burdens as value-based care expands, survey finds

Tracking patient progress and outcomes has become the top administrative challenge for clinicians, outranking insurance work, according to a new survey released by Twofold Health.

In the company’s 2025 Clinician Burden Report, 36.1% of 446 respondents said progress tracking was their No. 1 administrative burden.

Acquiring new clients ranked second at 20.6%, followed by working with insurance at 15.5%.

In the survey, clinicians used “progress tracking” to describe the work involved in documenting patient outcomes, tracking follow-up tasks between visits and completing required reports tied to newer payment and quality programs.

“Clinicians are spending countless hours on administrative tasks when they should be tracking the impact of their delivery and care on patients,” said Gal Steinberg, CEO of Twofold Health.

Higher burden in mid-sized practices

The survey found progress tracking was cited more often as practices got larger.

Among respondents in practices with 10 to 49 clinicians, 47.5% said progress tracking was their top challenge. The share was 35.8% for solo partitioners and 36.0% for small practices with 2 to 9 clinicians.

The report also shows 100% of respondents in practices with 50 or more clinicians chose progress tracking, though that category included only four respondents.

What clinicians mean by “progress tracking”

Among clinicians who selected progress tracking as their biggest challenge, 66.5% pointed to difficulties with standardized outcome measures. Another 25.5% cited homework or between-session task tracking.

“The administrative burden has become so overwhelming that it’s actually preventing us from doing the core clinical work we’re trained for,” said Vanessa Valles, LCSW-S, group practice owner at A New Start Counseling. “Progress tracking and documentation requirements take time away from direct patient care and therapeutic presence.

“When clinicians have tools that reduce administrative load, we see improvements in staff retention and reduced burnout,” she added.

The company surveyed 446 clinicians in October 2025, including mental health professionals and primary care physicians and nurse practitioners. The respondents were users of Twofold’s artificial intelligence (AI) clinical documentation platform.