Health Care Administration Inefficiencies: Lessons from the 2024 Medallion Report

Insights related to manual credentialing workflows, revenue impacts, clinician reliance on payer enrollment workflows, turnover and staffing challenges, and primary source verifications are revealed in the 2024 State of Payer Enrollment and Credentialing Report by Medallion. 

The survey included 337 provider-based US health care organizations and collected data for the purpose of investigating payer enrollment and credentialing workflows, staffing challenge impact, budget restraints, and more. 

The survey found that 52% of respondents reported entirely manual credentialing workflows. Reliance on manual credentialing for processes such as provider data collection, application receipt, credential file creation, review, primary source data verification, committee evaluations, and approvals can waste administrative resources. 

Another key finding is that 46% of respondents reported revenue impacts to their health care organization due to unoptimized enrollment workflows and slow turnaround times. Nearly 40% of health care professionals reported moderate reliance on manual processes in their payer enrollment workflows and 69% of respondents rely on 2 or more software tools to complete enrollment. 

“When you combine moderate reliance on manual processes and multiple software tools, it's no wonder healthcare teams are plagued with inefficient and unoptimized workflows, leading to long-term impact on an organization's bottom line,” said Medallion in a press release. 

Staffing is a growing concern throughout the health care industry, as evidenced by the finding that 57% of health care organizations experienced turnover and staffing challenges over the past year. The survey also identified that the turnover rate among enrollment and credentialing teams is significantly higher than other health care professionals. 

Primary source verifications, a single step in the multi-step credentialing process, required more than half a business day (more than 4 hours) to complete for around 60% of respondents. Similarly, almost one-third of respondents reported an end-to-end turnaround time of over 30 days.

"This report dives into how much time is spent on administrative tasks rather than patient care,” said Derek Lo, CEO and founder of Medallion. “We hope the findings within our '2024 State of Payer Enrollment and Credentialing Report’ help healthcare organizations see the impact they can have on efficiency and ultimately patient outcomes by implementing more effective solutions for back-office administration."

Reference
Nearly half of healthcare organizations report revenue impacts due to unoptimized workflows and slow turnaround times, according to Medallion survey. News release. PR Newswire. March 20, 2024. Accessed March 26, 2024. www.prnewswire.com/news-releases/nearly-half-of-healthcare-organizations-report-revenue-impacts-due-to-unoptimized-workflows-and-slow-turnaround-times-according-to-medallion-survey-302091694.html