Industry experts share provider data quality challenges and the impact of inaccurate directories at the hearing.
On May 3, the Senate Finance Committee held a hearing on removing barriers to mental healthcare, with a focus on improving provider directory accuracy. Jeff Rideout, MD, MA, FACP, President and CEO of IHA, was among several experts who testified at the hearing.
Rideout shared the work underway in California to improve provider directory accuracy through Symphony. He described the hundreds of data elements that comprise provider data and added that most of this data must be verified frequently. Rideout explained how Symphony is a central repository for provider directory data with standardized data sets, enabling provider organizations to attest once for multiple plans.
Robert Trestman, chair of psychiatry and behavioral medicine at the Virginia Tech Carilion School of Medicine Department of Psychiatry and Behavioral Medicine, echoed the need for standardization. He called for Congress to pass a standard that could reduce inconsistencies in format, reporting time, and sequence – ultimately reducing administrative burden for provider organizations.
In preparation for the hearing, Finance Committee staff conducted a “secret shopper” study. Staff reviewed directories from 12 Medicare Advantage plans across six states, calling 10 systematically selected providers from each plan, for a total of 120 calls. Of the 120 providers called, 33 percent had inaccurate, non-working phone numbers or did not return calls. Staff could only make appointments 18% of the time.
Also testifying at the hearing were the president of the American Medical Association, representatives from patient advocacy groups, and a patient who shared her challenges in finding a new psychiatrist after a job relocation across the country.
Read more about the Senate Finance Committee hearing.