Report: Health Plans Need To Do Better When It Comes to Care Navigation

13 Dec 2022
medcitynews.com
AHA
About 62% of Americans don’t trust their health plan when it comes to finding care, a new survey revealed Tuesday. It was commissioned by Ribbon Health, a healthcare provider data management company. The survey was conducted in October and included responses from 1,000 Americans. Care navigation seems to be the main area where consumers encounter challenges. More than one-third, or 38%, of respondents said they had a negative healthcare experience because of incorrect provider information on their insurer’s website. That’s not a complete shock given that more than half of provider directories have at least one inaccuracy, according to the Centers for Medicare & Medicaid Services. “This wasn’t surprising, but it is really disappointing to think about something that is addressable, like provider information, actually causing negative outcomes for people and their healthcare experiences,” said Nate Maslak, co-founder and CEO of Ribbon Health, in an interview. Correcting provider directories could increase members’ confidence in health plans. About 66% of respondents said they would have better trust in their health plan if they provided accurate information. People are also looking for more detail from these directories, like cost and quality of care, the report found. More than 60% of respondents said provider information like quality ratings, cost of care and demographics are important to them. Additionally, 53% of respondents said having a personalized health plan is the most important factor in having a positive healthcare experience. Finding a provider who has a high level of experience in treating their specific needs is also vital. Given these findings, what can health plans do? First and foremost, they need to fix their provider directories, Maslak said. While this won’t be easy to do, it’s what Americans are demanding from their insurers. “It’s not acceptable to live in a world, in our healthcare system, where half the information is wrong, so it has to become a bigger priority,” he said. Second, there needs to be more information on these directories, besides just phone numbers and locations, Maslak said. This includes information on cost of care, provider demographics and providers’ experience in treating certain conditions. “We as an industry, and health plans in particular, have to put our foot on the gas,” he said. “We have to move faster … I think we just have to do right by the consumer and make sure that people are able to access and find care conveniently and quickly and in a way that makes sense for them.” When asked if he thinks health plans will be open to these changes, Maslak responded that they’ll have to be. “The demands from consumers are pretty clear,” he said. “If a health plan wants to retain their members, if they want to gain market share in a given geography, they have to be able to differentiate for that member by providing a better healthcare experience.”
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