Provider Abrasion: What It Is and How to Avoid It

In the complex world of healthcare, the relationships between payers and providers can often become strained. This strain, commonly referred to as "provider abrasion," signifies the friction that can arise from misunderstandings, miscommunications, and procedural inefficiencies. These challenges can impact the efficiency of care delivery and the overall satisfaction of both providers and patients. In this post, we will delve into the concept of provider abrasion and explore effective strategies to reduce it, fostering smoother and more productive collaborations in the healthcare ecosystem.

What is Provider Abrasion?

Provider abrasion refers to the strain or frustration providers experience due to frequent interactions with insurance companies, network administrators, and pharmaceutical or medical device sales representatives that feel intrusive, unproductive, or excessively time-consuming. These interactions can become a source of stress, often resulting in “abrasion” when doctors feel pressured by administrative demands, marketing pushes, or repetitive follow-ups on demographic information, roster updates, prescriptions, treatments, or procedural adherence. This friction can lead to a decreased willingness to engage with representatives or administrative protocols, impacting the relationship between healthcare providers and the broader healthcare system and potentially affecting patient care. Provider abrasion is a substantial concern because healthcare is increasingly complex, and administrative burdens are rising, sometimes at the expense of patient-facing time.

What Are the Implications of Provider Abrasion?

Provider abrasion can have wide-ranging implications across the healthcare system, affecting patient care, provider satisfaction, and the adequacy of a healthcare network. For an organization, the cost of replacing a physician can range from $500,000 to more than $1 million per doctor. This estimate includes recruitment, sign-on bonuses, lost billings, and onboarding costs for replacement physicians. But that’s not the only impact.

• Practices are typically subjected to a nearly constant barrage of requests for directory information on varying schedules, using different technologies, and in different formats. On average, a typical practice must respond to requests associated with 20 health plan contracts, contributing to provider abrasion by causing additional administrative burden and an environment of frustration.
• Over time, frequent and repetitive administrative tasks, insurance company follow-ups, and interactions with payers can lead to disengagement among providers. This may reduce their willingness to collaborate to provide crucial demographic data updates that have far-ranging impacts on directory and claims payment processes downstream in the provider lifecycle.
• When providers are overwhelmed or frustrated, their focus can be diverted from patient care. Time spent on administrative tasks or repetitive interactions with non-clinical staff may reduce the amount of quality, direct care time with patients, which can impact diagnosis, patient education, and follow-up care.
• The emotional toll from continuous administrative demands can contribute to burnout. Burnout, in turn, leads to higher rates of depression, anxiety, and even attrition within the profession. Burnout can be costly, as it may result in high turnover rates, increased recruitment expenses, and reduced workforce morale.
• Providers facing constant friction may be less inclined to strictly adhere to protocols requiring extensive administrative interaction, especially if the burden aligns differently with the benefits for patient outcomes. This can impact network adequacy for health plans, as well as the uniformity and quality of care providers deliver within healthcare systems.
• Dissatisfied providers may express their frustrations to patients, which can lead to negative perceptions of the healthcare system. Patients may lose trust in their healthcare providers and payers. Ultimately, this can result in increased patient complaints, higher churn rates, and a greater likelihood of patients seeking care elsewhere.

What Can Be Done to Reduce Provider Abrasion?

Reducing provider abrasion requires a combination of process improvements, policy changes, and technology integrations to make administrative and non-clinical interactions more efficient and supportive of patient care. Here are five approaches:

• Streamline administrative workflows. Simplifying and automating routine tasks, such as insurance pre-authorizations and billing processes, can significantly reduce providers' administrative burden. Implementing efficient provider data management systems with easy-to-navigate templates, automated documentation tools, and seamless platform integration can streamline data entry, allowing providers to spend more time on patient care than paperwork.
• Implement centralized communication platforms. Communication channels between providers, insurance companies, and pharmaceutical representatives can become cluttered and inefficient. By creating a centralized platform that consolidates necessary communication in a structured way, providers can receive and respond to essential information without facing repetitive or disruptive contact from multiple parties. This approach also enables providers to access the information on their schedules, minimizing interruptions during clinical hours.
• Limit and optimize representative interactions. Healthcare organizations and provider networks can limit the number of in-person or virtual meetings between representatives and providers to reduce abrasion from frequent administrative asks. When interactions do occur, they should be value-driven, focusing on clinically relevant updates rather than purely promotional information. Training representatives to be sensitive to time constraints and ensuring they offer helpful, concise data can make interactions more beneficial and less intrusive.
• Enhance decision-making autonomy. Reducing the need for providers to update information in multiple places can empower providers to make swift administrative decisions so they can focus on their patient care. Offering streamlined protocols for high-frequency administrative requests can lessen the load on providers and enable them to focus their time and energy on patient care.
• Promote self-service resources and tools. Providing access to online portals where providers can quickly obtain information about insurance coverage, formulary changes, and medication approvals without direct interaction can reduce frustration, i.e., provider abrasion. These resources allow providers to access up-to-date information as required, removing the friction of back-and-forth communication and empowering providers to make quick, informed decisions independently.

How Certify Can Help

Certify transforms the provider experience by simplifying the credentialing, licensing, and payer enrollment processes. The platform streamlines these essential workflows by minimizing the amount of information providers must submit, giving providers complete visibility into every application stage. This transparency allows them to easily track progress and stay informed on the status of their credentialing, further reducing abrasion.

Our system reduces administrative burden and eliminates bottlenecks, accelerating the application process. Providers can enter networks faster and start seeing patients sooner, ensuring they are compensated more quickly and accurately. This accelerated onboarding directly translates into a positive experience for providers who no longer have to navigate complex, drawn-out processes. Certify's efficient and transparent approach enhances provider satisfaction, making them enthusiastic members of health plan networks.

By reducing provider abrasion, Certify creates healthier, more resilient networks. Happy providers are engaged providers, which leads to better patient care and strengthens the healthcare ecosystem. Certify's streamlined process means less friction for providers and healthier networks overall, making it easier for healthcare organizations to focus on what matters most — quality care.

To discover how Certify can help your organization streamline provider onboarding, improve network health, and reduce administrative costs, book a free demo or contact our sales team at sales@certifyos.com. Let Certify empower your network with the efficiency and transparency it deserves.