Industry
Providers Report Rising Denial Rates Despite Revenue Cycle Automation Gains
Health systems have invested heavily in revenue cycle automation over two decades, with the 2025 CAQH Index estimating $258 billion in avoided administrative costs in 2024. Despite these efficiency gains, denial rates continue to climb, with 41 percent of providers now reporting at least one in ten claims denied—a figure that has increased annually. The trend suggests automation alone has not resolved underlying issues driving claim denials, including prior authorization requirements, documentation standards, and payer policies.
Why it mattersRising denial rates directly affect Medicaid MCO provider networks and administrative costs, as plans face increased appeals, disputes, and potential adequacy concerns when contracted providers struggle with claim rejections.