MedEvolve’s new touch-level benchmarks, based on 30 million revenue cycle interactions, reveal hidden administrative burden, denial-related rework, and a critical gap in how healthcare measures operational performance
, /PRNewswire/ — Healthcare organizations have spent decades measuring revenue cycle outcomes such as denial rates, clean claim rates, days in accounts receivable, collections, and net revenue. While these metrics provide visibility into results, they reveal little about the operational effort required to achieve them.
Drawing on more than 30 million revenue cycle interactions across healthcare organizations nationwide, MedEvolve found that a substantial share of operational effort is devoted to activities that do not directly advance claims toward payment. These activities include preventable denial follow-up, eligibility issues, authorization breakdowns, payer status checks, documentation rework, claim corrections, rebilling efforts, and other forms of administrative friction.
MedEvolve’s findings highlight a broader issue within healthcare revenue cycle operations. While organizations have become increasingly sophisticated at measuring financial outcomes, they often lack visibility into the work required to achieve them.
“For decades, healthcare has managed revenue cycle performance using lagging indicators,” said Matt Seefeld, CEO of MedEvolve. “We know denial rates. We know days in accounts receivable. We know collections. What most organizations don’t know is how much work was required to achieve those outcomes—or how much of that work could have been avoided.”
As healthcare organizations face workforce shortages, rising labor costs, increasing denial complexity, and growing pressure to deploy artificial intelligence, the administrative burden continues to grow.
Hidden Costs of Getting Paid
While denial rates and reimbursement metrics remain important, they offer limited visibility into the operational burden occurring behind the scenes. Every eligibility issue, authorization failure, claim correction, documentation request, or payer follow-up creates additional work for staff long after a claim is submitted.
MedEvolve refers to this hidden burden as the Touch Tax: the cumulative cost of human- and AI-generated work that fails to produce a financial outcome.
Early benchmark analysis indicates that avoidable work frequently represents the majority of operational activity within revenue cycle operations. MedEvolve found that avoidable touches often account for 75% to 90% of measured revenue cycle activity, while touches associated with preventable denials can account for 25% to 35% of operational effort.
These findings suggest that healthcare organizations may be dedicating substantial workforce capacity to work that could be prevented, automated, or eliminated through improved operational visibility and process design.
“When organizations discover how much effort is tied to preventable work, the conversation changes immediately,” Seefeld said. “The question is no longer whether they need more staff. The question becomes why so much work exists in the first place.”
AI Accountability and Operational Visibility
MedEvolve’s findings also raise important questions about how healthcare organizations evaluate automation and artificial intelligence initiatives. Many AI solutions measure tasks completed, activities performed, or transactions processed. However, those measurements do not necessarily indicate whether total work has been reduced.
An automated action may eliminate one task, but if that same claim later requires denial management, payer escalation, rebilling, or manual correction, the underlying burden remains. “Healthcare is measuring AI activity when it should be measuring AI outcomes,” Seefeld said. “The real question is whether technology reduces the total effort required to achieve payment.”
To address this challenge, MedEvolve developed a new set of operational indicators designed to measure the work behind reimbursement. Unlike traditional financial metrics, this framework helps organizations identify administrative friction, avoidable effort, and process breakdowns before they appear in financial reports.
Key areas measured include:
- Avoidable touches and repeated claim activity
- Denial-related workload and payer friction
- Workflow breakdowns that generate rework
- Effort required to achieve payment outcomes
- Opportunities to reduce administrative burden upstream
As healthcare organizations continue to balance workforce constraints, financial pressure, and AI adoption, operational visibility into the work behind reimbursement is becoming increasingly important.
“The healthcare industry has spent decades measuring outcomes while largely ignoring the workflow required to achieve them,” Seefeld said. “Organizations that learn to measure and reduce unnecessary work will create a significant competitive advantage in the years ahead.”
About MedEvolve
MedEvolve is rewriting the rules of the revenue cycle, helping healthcare organizations move beyond labor-intensive, reactive reimbursement work. Its Effective Intelligence® (Ei) platform provides visibility into the operational activity behind reimbursement, enabling leaders to identify avoidable effort, streamline workflows, and support scalable automation.
By reducing unnecessary touches and improving process control, MedEvolve helps organizations accelerate resolution, increase predictability, and operate more efficiently in an increasingly complex payer environment. As healthcare organizations face growing administrative burden, rising denial rates, and increasing pressure to adopt AI, MedEvolve helps healthcare organizations move beyond traditional lagging indicators by providing visibility into the operational activity that drives reimbursement performance.
Learn more at https://MedEvolve.com.
References
- American Hospital Association. (2026, March). 5 things to know about the costs of caring report 2026. aha.org/system/files/media/file/2026/03/5-Things-to-Know-about-the-Costs-of-Caring-Report-2026.pdf
- Centers for Medicare & Medicaid Services. (2024, January 17). CMS interoperability and prior authorization final rule (CMS-0057-F). cms.gov/priorities/burden-reduction/overview/interoperability/policies-regulations/cms-interoperability-prior-authorization-final-rule-cms-0057-f
- Experian Health. (2025, October 10). Healthcare claim denial statistics: State of claims report 2025. experian.com/blogs/healthcare/healthcare-claim-denials-statistics-state-of-claims-report/
- American Medical Association. (2025). 2025 AMA prior authorization physician survey. American Medical Association. ama-assn.org/system/files/prior-authorization-survey.pdf
- Kodiak Solutions. (2025, May 21). Rate of initial denials of medical insurance claims continued to rise in 2024, Kodiak Solutions proprietary data show. Business Wire. businesswire.com/news/home/20250521892947/en/Rate-of-initial-denials-of-medical-insurance-claims-continued-to-rise-in-2024-Kodiak-Solutions-proprietary-data-show
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SOURCE MedEvolve
