One-fourth of medical claims payments are still fully manual
The movement of money is crucial to making the health care system work. Claims payment delivery plays a critical role here, with digital processes far exceeding manual processes in terms of efficiency, effectiveness, payer experience and savings.
In recent years, payers have made great strides toward shifting to digital processes:
- Claims automation is on the rise, and most payments are now electronic
- 67% of health plans are in the process of going paperless2
- 50% of health plans have a strategy to streamline or automate their claims payment system2
But various factors — from resource constraints to resistance to change — keep payment delivery from being a priority. As a result, paper checks still make up 25% of medical claims payments.3 And because they require end-to-end human interaction, the cost is steep.
Administrative simplification could save up to $265B annually
The Council for Affordable Quality Healthcare, Inc. (CAQH) is a nonprofit organization that tracks electronic adoption of administrative functions across the health care industry. It offers compelling evidence to shift to fully automated administrative processes.
According to the 2022 CAQH Index, there was a 28% increase in medical administrative transactions over the prior year and a 15% increase in time to conduct transactions.3 Transitioning to electronic payments would save payers $0.48 per claims payment transaction.3
Then consider this. According to a 2021 McKinsey report, 30 known administrative interventions could save U.S. health care up to $265 billion annually. Streamlining claims processing and related support functions represents approximately $175 billion of that total.4
Key factors when choosing a payment delivery solution
Given all this, it's imperative that health plans implement a digital strategy for their payment delivery solution. This requires finding a partner with a solution that delivers on multiple fronts — streamlining the payment process, boosting efficiency and accuracy, and lowering administrative costs.
To get started, focus on finding a payment delivery process that aligns the right payment method with provider needs. Look for solutions that:
- Are easily integrated into existing systems
- Offer multiple forms of payment and a track record of increasing electronic adoption; electronic payments have proven ROI by lowering print and postage costs
- Ensure providers of an easy-to-use system with fast, efficient payments in the modality of choice, freeing them to focus on patient care
Speak with Optum Financial about payment innovation options
We know that modernizing processes is a big step — one that requires a sound plan and the right tools and support. To learn how we can help you address inefficient processes, provider friction, varied payment types and other pain points, visit optum.com/healthpayments.