Payer and Provider Contracting Process Analysis

This issue brief presents findings from the 2025 CAQH Index, focusing on the contracting practices between payers and providers in healthcare. It outlines how these contracting processes are primarily manual and document-driven, which creates inefficiencies and inconsistencies across the industry. The brief details the reliance on outdated tools such as spreadsheets and emphasizes the need for modernization in contracting practices. It examines the differences in contracting approaches based on the size and resources of healthcare organizations, noting that larger practices tend to adopt more advanced tools compared to smaller ones. The document also discusses the varying priorities among different specialties in healthcare, which affect their willingness to change contracting formats. By identifying the barriers to modernization and the fragmented nature of current practices, the brief suggests potential opportunities for improvement that could alleviate the administrative burden on healthcare providers and enhance the overall efficiency of the contracting process.