ROI Breakdown of Switching to a Multi-Payer Provider Portal

Switching to a multi-payer provider portal is no longer just a technical upgrade—it’s a strategic move for health plans looking to reduce costs, streamline workflows, and improve provider collaboration. As administrative complexity increases and provider networks feel the strain, many organizations are reassessing their reliance on single-payer or homegrown portals that can’t scale with evolving demands.

Today’s forward-thinking health plan executives are embracing multi-payer provider portals to centralize transactions, simplify provider engagement, and reduce friction across the care continuum. By consolidating interactions into a single, standardized platform, health plans can drive operational efficiency while maintaining a competitive edge in a rapidly changing industry.

In this blog, we’ll explore the financial and operational benefits of switching to a multi-payer provider portal, including lower administrative costs, fewer provider touchpoints, and a stronger foundation for scalable growth.

Why make the switch? The ROI speaks for itself.

A recent case study shows how transitioning to a multi-payer platform—like Availity Essentials™—can drive measurable financial and operational gains. Here’s how those savings add up:

Reduced Call Volume

Digitizing provider interactions reduced calls by 20–30%, with estimated annual savings of $500K+ based on 600K calls at $4 each

Digitization of Authorizations and Appeals

Moving manual processes to digital reduced transaction costs dramatically. With over 341K authorizations and 360K appeals, this change saved over $1.7M annually.

Portal Infrastructure Maintenance

Eliminating the need to support an internal portal for 2 million members led to over $1M in savings, covering maintenance, infrastructure, and security costs.

Combined, these improvements total more than $3.2M in conservative estimated savings.

Reinvesting in What Matters Most

With measurable savings in hand, your organization can reinvest in initiatives that advance care, reduce costs, and meet enterprise priorities.

Invest in Patient-Centered Programs

Use the freed-up budget to launch or expand initiatives that drive better health outcomes and member satisfaction.

Upgrade Technology

Improve interoperability, analytics capabilities, or mobile experiences to stay ahead in a digital-first world.

Support Community Health

Channel funds into community-based care initiatives, addressing social determinants of health and improving equity.

A Competitive Edge Through Provider Engagement

Beyond cost savings, a multi-payer portal can deliver a significant strategic advantage by reducing provider friction and improving collaboration.

One health plan saw this firsthand—provider feedback was overwhelmingly positive. Satisfaction surveys and quality assurance reviews revealed reduced frustration and a clearer understanding of electronic submissions. Providers appreciated the streamlined process and reported fewer issues with claims submissions.

Higher provider satisfaction

Streamlining administrative processes helps providers complete tasks such as eligibility verification, prior authorization, and claims submissions more efficiently. This leads to a seamless, intuitive experience that fosters greater satisfaction, leading to stronger provider adoption and engagement.

Reduced administrative burden

By eliminating multiple payer portals, manual work is reduced, freeing up time spent on administrative tasks. As a result, providers can focus more on what truly matters—delivering quality patient care.

Improved provider-plan collaboration

A centralized, real-time exchange keeps providers and payers aligned on critical transactions, minimizing miscommunication and delays. The result? Smoother operations, better relationships, and a more competitive network.

Switching to a Multi-Payer Provider Portal Delivers 1.45x ROI—and That’s Just the Start

With first-year costs estimated at $2.4M, the transition to a multi-payer portal delivered a 1.45x ROI in its first year. And this doesn’t even factor in the harder-to-quantify yet highly valuable benefits, such as enhanced provider trust, faster reimbursement, and cutting-edge cybersecurity. All of which play a crucial role in driving long-term financial and operational success.

For health plans looking to scale efficiently, reduce administrative burden, and enhance provider collaboration, the case for transitioning to Availity’s multi-payer portal is clear. Availity Essentials can provide a foundation for seamless payer-provider transactions, equipping health plans with the connectivity, automation, and data insights needed to optimize performance and reinvest in mission-critical priorities.

Ready to experience the difference? Click the button below and fill out a form to learn more about how Availity can transform your provider engagement strategy.

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References

The figures mentioned are based on reported results and are estimates. Actual results may vary depending on individual circumstances.

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