Patients calling a U.S. healthcare line wait an average of 4.4 minutes on hold, and 52% finish the call with the issue resolved. The contact center industry treats 70% first call resolution as the floor for a healthy operation. The measured result misses the published bar by more than double.
We pulled the performance thresholds that federal regulators and benchmarking firms publish. We then set those targets against measured results from facility-level research, federal wage releases, and 2026 practice polling. Every figure traces to the organization that printed it, and we published only the figures we confirmed. What follows opens on the targets a healthcare phone operation gets graded against, then works down to what one staffed phone seat costs a practice each year.
Key Takeaways
- A health plan’s call center meets Centers for Medicare & Medicaid Services (CMS) standards when it keeps the average hold time under 2 minutes and drops fewer than 5% of calls.
- Patients report 52% first call resolution, well under the 70% to 79% band SQM Group calls a good rate.
- Eligibility and prior authorization work consumes 45% of practice staff phone time, ahead of scheduling at 31%.
- The contact center industry average cost per call reaches $9.10, and the average cost per resolved call reaches $12.74.
What a Healthcare Call Center Gets Graded Against
Federal regulators and benchmarking firms publish the thresholds a phone operation gets measured on, and the target moves depending on who does the grading. Our analysis below collects the standards in current use:
| Benchmark | Published Target | Publisher |
|---|---|---|
| Service level | 80% of calls answered within 20 seconds | SQM Group |
| Average hold time | 2 minutes or less | CMS Part C and Part D call center monitoring |
| Disconnect rate | 5% or less | CMS Part C and Part D call center monitoring |
| Average speed of answer | 30 seconds or less | Veterans Health Administration |
| Call abandonment rate | 5% to 8% | SQM Group |
| First call resolution | 70% to 79%, world class at 80% or higher | SQM Group |
Key Insights:
- CMS and the Veterans Health Administration both draw the abandonment line at 5%, under the 5% to 8% band the broader contact center industry accepts.
- World class first call resolution starts at 80%, and the strongest industries SQM measured averaged 73% to 75%.
How Measured Performance Compares to the Targets
Published targets and measured results diverge sharply once a study counts actual calls. Research across 285 medical facilities and a 2025 survey of patients and call center leaders put that distance in numbers, as the table below shows:
| Metric | Measured Result | Source |
|---|---|---|
| Hold time patients report | 4.4 minutes | Hyro healthcare call center report, 2025 |
| First call resolution patients report | 52% | Same report |
| Patient satisfaction with call center service | 51% | Same report |
| Average speed of answer, 285 facilities | 87.1 seconds, improving to 69 seconds | Veterans Health Administration study |
| Abandonment rate, same facilities | 12.0%, improving to 8.3% | Same study |
| Facilities still missing one or both targets | Nearly 80% | Same study |
| First call resolution average, all industries | 69%, ranging from 43% to 88% | SQM Group 2024 benchmark |
Key Insights:
- Patients wait more than twice the 2 minute ceiling CMS applies to plan call centers.
- A two-year improvement program across 285 facilities cut abandonment from 12.0% to 8.3% and still left nearly 80% of centers short of goal.
Where Practice Phone Time Actually Goes
Most of the morning queue has nothing to do with booking an appointment. MGMA polled practice leaders in March 2026 on how staff spend phone time, and payer work outranked booking, as our data indicates below:
| Phone Task | Share of Staff Phone Time |
|---|---|
| Eligibility and prior authorization | 45% |
| Scheduling | 31% |
| Patient intake | 9% |
| Prescription refills | 6% |
| Other tasks | 9% |
Key Insights:
- Verification and authorization calls take 45% of phone time, so the person booking appointments spends most of the day on payer work.
- Eligibility and scheduling together account for 76% of phone time, concentrating the queue in work a trained assistant completes without a clinician.
What One Patient Call Costs to Handle
Every patient call has a price, and a call that fails on the first attempt costs more than one that resolves. SQM Group benchmarks spend per contact across North American centers, as the table below sets out:
| Cost Measure | Published Figure |
|---|---|
| Industry average cost per call | $9.10 |
| Average cost per call resolution | $12.74 |
| Cost per resolution, highest performing agents | $10.92 |
| Cost per resolution, lowest performing agents | $14.56 |
| Operating cost change per 1 point of first call resolution | 1% reduction |
| Customer satisfaction change per repeat contact | 15% drop |
| Share of call center budget spent on labor | 43% |
Key Insights:
- The best and worst agents differ by $3.64 on every resolution, so training moves cost faster than call volume does.
- Labor absorbs 43% of the budget, which puts the rate on the phone seat ahead of every other spending line.
What the In-House Phone Seat Costs Your Practice
Experian Health found that 64% of providers reported staffing shortages cut into patient access in 2026. A practice hiring in-house pays the wage, and then pays again for benefits. Health insurance, paid leave, retirement, and payroll taxes all get added to the hourly rate. Federal releases the price of the seat a practice would otherwise hire, as the table below shows:
| Cost Benchmark | Figure | Source |
|---|---|---|
| Median annual wage, customer service representatives | $44,770 | U.S. Bureau of Labor Statistics, May 2025 |
| Median hourly wage, same role | $21.53 | U.S. Bureau of Labor Statistics, May 2025 |
| Median annual wage, secretaries and administrative assistants | $48,310 | U.S. Bureau of Labor Statistics, May 2025 |
| Employer benefit cost, private industry | $14.07 an hour, 30.0% of compensation | BLS Employer Costs for Employee Compensation, June 2026 |
| Benefit load on top of wages (calculated) | 42.9% | Calculated from that BLS release |
| Fully loaded annual cost, one in-house phone seat (calculated) | $63,963 | Calculated from the wage and benefit figures above |
| Health care separations, annual average | 2.9% a month | BLS JOLTS, 2025 |
| Dedicated virtual assistant at $10.95 for 2,080 hours | $22,776 | DocVA |
| Annual difference (calculated) | $41,187 lower | Calculated from the loaded cost and the DocVA rate |
Key Insights:
- Every wage dollar costs an employer $1.43 once benefits land, putting a four-seat phone team roughly $76,000 above a budget written at wages.
- Health care employers lose 2.9% of staff a month, so a six-person phone team gives up about two people a year.
Further Reading
About This Report
This report was created for DocVA.
Sources
- Centers for Medicare & Medicaid Services
- SQM Group
- SQM Group
- National Library of Medicine
- Medical Group Management Association
- Hyro
- U.S. Bureau of Labor Statistics, Customer Service Representatives
- U.S. Bureau of Labor Statistics, Employer Costs for Employee Compensation
- U.S. Bureau of Labor Statistics, Job Openings and Labor Turnover Survey
- Experian Health
- DocVA
