New Service Launches to Improve Navigation of the State's Fragmented Healthcare Directories
SAN FRANCISCO, Jan. 8, 2019 /PRNewswire/ -- The Integrated Healthcare Association (IHA) today launched a new service, the Symphony Provider Directory, formerly known as the California Provider Directory Utility (PDU). The centralized online service will improve California's healthcare provider directories by serving as a platform for plans and providers to exchange and reconcile provider information, resulting in improved data quality and more efficient processes. Funded by a $50 million grant from Blue Shield of California, the Symphony Provider Directory is the result of a cross-industry collaboration of plans, providers, purchasers and regulators.
Today, maintaining provider directories is an administratively burdensome and expensive process that does not always produce reliable results. This in turn means consumers often rely on inaccurate information when determining what providers are in a plan's network and if they are accepting new patients. Recognizing IHA's role and history of success as a neutral convener of healthcare stakeholders, the California Department of Managed Health Care (DMHC), Blue Shield of California and a multi-stakeholder advisory committee selected IHA in 2017 to develop a statewide centralized provider directory utility.
Just a year later, The Symphony Provider Directory now enables health plans to maintain more up-to-date and accurate information such as provider demographics, panel status and health plan product and network details in their consumer-facing directories so that consumers can make informed decisions about their coverage and care. Symphony's provider data will also be used to populate multi-plan directories such as Covered California's provider directory.
"Implementing a statewide provider directory in California, one of the nation's most complex healthcare markets, is not an easy task," said Jeffrey Rideout, M.D, President and CEO of IHA. "This is much more than a complex IT project. This is an industry-wide commitment to improve the healthcare system in California. IHA's role is to drive alignment and establish an effective and sustainable platform that supports the complex needs of health plans, providers and ultimately healthcare consumers."
IHA worked with its technology partners, Gaine Healthcare and Availity, to successfully soft launch the utility in August 2018 with participation across the state from three of the largest health plans in California (Anthem Blue Cross, Health Net and Blue Shield of California), two large provider organizations (Hill Physicians Medical Group and Global Care Medical Group IPA) and ten independent practices and clinics.
"We must simplify and standardize our healthcare system in order to transform it," said Paul Markovich, Blue Shield of California President and CEO. "That includes ensuring essential healthcare provider information is accurate and easy to access. The development of a centralized provider directory utility in California is a strong step in this direction, and one of many investments we have already made or will be making in the future to transform healthcare for all Californians. We are proud to collaborate with IHA to make this happen."
In the soft launch, IHA established baselines around data accuracy, ensured that the technology platform supported state and federal compliance requirements and identified opportunities to optimize internal and shared processes between health plans and providers. Results from the soft launch show the variances in the existing information and highlight the opportunity to significantly improve the quality of provider data. For example, 31% of providers that should be listed in a health plan's online directory, were not. Symphony will continuously make improvements based on participant feedback and the network effect associated with multiple organizations participating in a single platform. This multi-organizational participation will also more rapidly increase functionality and improve the provider portal in 2019.
The more plans and providers that participate, the better the data quality and, ultimately, the better equipped consumers will be when making decisions about their coverage and care. Working towards this goal, IHA aims to achieve a critical mass of participation in the Symphony Provider Directory by 2023, including at least 80 percent of plans and providers in California. To encourage participation in the utility, the Symphony Provider Directory will be fully subsidized for health plans and provider groups for the duration of 2019.
"Ensuring enrollees have accurate provider directories is an important component of access to care," said Shelley Rouillard, Director of the Department of Managed Health Care, California's health plan regulator. "I applaud everyone working on this industry-wide solution, led by IHA, to ensure enrollees receive accurate information and gain efficiencies for both plans and providers. I strongly encourage all health plans and providers in California to join this effort."
Key Benefits of the Symphony Provider Directory include:
- Growing Network of Participants: three of California's largest plans (Anthem Blue Cross, Health Net and Blue Shield of California) are currently on the platform, with more plans and provider organizations onboarding throughout 2019. This means that all providers in those plan networks can update their information in one place.
- Compliance Made Simpler: Symphony enables plans and providers to achieve compliance with SB 137, Medicare Advantage, and Medi-Cal requirements while decreasing the administrative burden on plans and providers.
- Seamless Experience: Symphony is designed to integrate with existing systems and processes by simplifying the data management process every step of the way, reducing administrative work and provider and plan fatigue.
- Enhanced Data Quality: leverages primary sources and standardized data policies to facilitate a transparent process so that plans and providers can work together to improve data quality over time.
The Symphony Provider Directory is available now for health plans and provider organizations. Join the movement. To learn more and sign up, please visit www.symphony.iha.org.
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