Abrasion Index uncovers healthcare’s costly stalemate

Healthcare leaders do not need another reminder that administrative complexity is high. They live it every day across multiple workflows, including claims management, medical record attachments, prior authorizations, and payment integrity processes.

The 2026 Availity Abrasion Index was created to give the industry a shared way to describe and measure the administrative friction that shapes payer-provider relationships. Payer-provider abrasion is not an abstract complaint. It is a measurable operating condition that slows work, increases administrative cost, creates rework, and strains collaboration across mission-critical workflows.

This report is designed to establish a baseline for that friction, identify where the greatest abrasion exists, and point toward practical opportunities to reduce it.

About the Availity Abrasion Index

The Availity Abrasion Index measures abrasion between more than 60 payer and provider leaders across six critical administrative areas on a five-point scale, including:

• Eligibility and benefit verification
• Prior authorizations
• Claims management
• Medical record attachments
• Denials
• Payment integrity

More than a measure of abrasion, the Index identifies the root cause of abrasion and provides guidance for finding common ground between payers and providers.

Key Findings

The Availity Abrasion Index validates a broad pattern of administrative distrust and friction. The report’s opening framing is that the hardest parts of healthcare are often not the care itself, but the administrative back-and-forth between stakeholders. The Availity Abrasion Indexpositions that friction as both operational and relational, with trust erosion showing up alongside cost and delay.

Payers rate abrasion higher than providers for most processes. This is one of the most strategically important findings for executive audiences. It reinforces that the report is not framed as provider grievance research alone. Health plans themselves report even greater abrasion in many workflows, which strengthens the credibility of the broader industry problem statement.

Prior authorization, denials, and payment integrity are the clearest priority areas. The report repeatedly identifies these three processes as the top shared starting points for industry action.

Even lower-friction areas still generate meaningful downstream burden. Eligibility and benefit verification is presented as lower abrasion relative to other processes, but the report warns that “lower” does not mean solved. Errors and outdated data often show up later as denials, recoupments, claw backs, and patient/provider friction.

Manual and non-standard workflows remain a major drag. Across multiple chapters, the report points to fragmented intake, incomplete documentation, inconsistent criteria, manual record exchange, non-standard formats, and vendor sprawl as recurring causes of abrasion.

Reserve Your Copy Today

The Availity Abrasion Index shows that this is not a simple story of one side being right and the other wrong. It is a story about a system where complexity compounds, trust erodes, and administrative work becomes harder to navigate than it should be.

The upcoming Abrasion Index puts a name and a framework around that experience.

For now, one thing is already clear: this conversation is bigger than burden. It is about how healthcare organizations work together when the rules of exchange are inconsistent, the stakes are high, and the downstream effects reach far beyond the back office.

Sign up on our pre-launch landing page to receive your copy of the Availity Abrasion Index on April 27.

Reserve your copy HERE.