Survey: U.S. physicians pay billions annually to maintain provider directories

November 20, 2019

Streamlining how physicians collect and share directory information can save physician practices more than $1.1 billion.

Directory maintenance costs physician practices across the U.S. $2.76 billion annually, according to a new survey from the Council for Affordable Quality Healthcare, Inc. (CAQH).

The survey was performed in September 2019 as CAQH polled 1,240 physician practices. It found that updating that information costs each practice an average of $998.84 a month, or the equivalent of one staff day per week.

"Our nation's fragmented approach to maintaining provider directories is not only a burden on physician practices, it may be undermining the accuracy of the data," says April Todd, CAQH senior vice president for CORE and Explorations, in a news release on the results of the survey. "Health plans rely on the information providers give them. If we minimize the requests that drive provider burden, we can improve the accuracy of the data."

The survey blames the burden of maintaining directories in part on the average physician’s practice updating information on 20 health plans and large practices updating more than 30 health plan contracts. While individual health plans are looking to minimize their burden, practices are still required to respond to multiple requests and submit information in varying formats on different schedules for each plan, which is taxing on practice resources and may lead to errors.

The release cites studies on these systems performed by the Centers for Medicare & Medicaid Services which found that as much as half of the information in directories may be inaccurate which can create barriers to care and lead to higher out of pocket costs.

Another survey, released in January 2018 by the American Medical Association, found that 52 percent of physicians said their patients encounter coverage issues at least once a month because of inaccurate directories and 67 percent of respondents expressed interest in using just one interface to send and update information to payers, the release said.

CAQH discovered that practices which only use one channel for all plans spend 39.6 percent less per month than practices that use multiple approaches. This approach could save the average physician practice $4,746 annually, and could save at least $1.1 billion annually nationwide, the survey said.

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