What healthcare payment complexity is costing you (and how to measure it)
When payment infrastructure works, nobody notices it. Payments are accurate the first time, corrections are rare, and there’s no questions to ask about why a provider got paid twice or a check was returned. However when a payment fails — teams notice their payment infrastructure.
The industry benchmarks define the gap between complexity and simplicity, and six years of ECHO’s payment data shows how far it can close.
Why healthcare payments are so complex
Healthcare payment complexity is structural. It comes from legacy systems that weren’t designed to integrate across the ecosystem, a heavily regulated industry, and workflows that don’t share data with one another.
Years ago, banking and retail modernized how money moves. Healthcare payments haven’t kept pace and according to McKinsey, the industry is behind nearly every other data-heavy industry when it comes to going digital. This heightened complexity comes at a cost.
What that complexity costs the industry
While medical electronic claim payment adoption reached 78%, each manual transaction takes staff time that an electronic one mostly skips, and that time can show up on the books.
According to the 2025 CAQH Index, a manual administrative transaction costs medical providers an average of $8.03 to process, compared with $2.65 for an electronic one. Automation has already helped the industry avoid $258 billion in administrative costs, and CAQH estimates another $21 billion in savings are still within reach.
Manual payments carry exposure on top of cost. In 2025, 76% of organizations experienced attempted or actual payments fraud, and checks were the most frequent target, with 58% of organizations reporting check fraud. Digital payments reduce that exposure without erasing it, which makes an operation far more defensible.
What the benchmark looks like
ECHO® pulled six years of its own payment processing records (2020-2025) across combined health plan and TPA activity. The figures here measure 2025 results against 2020 starting points.
The industry spent years climbing to 78% electronic claim payment adoption.
ECHO’s Payment Network runs at 92.3% digital share today.
Returned payments (the ones that come back for bad or outdated account data) moved even further. ECHO’s return rate fell from an industry low 2.56% to an unheard of 0.02%, a 99.2% reduction. In 2020, about $1 of every $40 came back. In 2025, it was $1 of every $5,000.
Paper checks dropped from 17.5% of volume to 7.7%, less than half of where they started. ACH now carries 88% of total payment volume, up from 63% in 2020. Behind those results is the ECHO Payment Network, with more than 1.6 million unique provider and vendor connections, and the largest in the industry.
The questions that show you where you stand
The Healthcare Payment Simplification Scorecard turns those benchmarks into six questions about your operation.
Here are three below, and the other three come with the download:
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1. What percentage of your outbound payments are digital?
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2. How many separate platforms does your team use to manage payments?
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3. What percentage of payments are returned for bad data?
Each question maps to a benchmark above, so your answer lands on the same scale ECHO measures against.
Put a number on it
Healthcare payment complexity isn’t going away. What your operation can control is how much of that cost it carries needlessly, and whether anyone’s put a number on it.
In the same amount of time it took you to read this, the Scorecard gives you that number.
Download the Healthcare Payment Simplification Scorecard to see where your operation stands against the industry baseline and ECHO’s benchmark.