Nate Maslak, Dr. Manish Oza, and Dan Rosenthal join the Becker’s Healthcare Podcast to discuss how provider data affects stakeholders across the industry, where health plans should invest in innovation, and their vision for the future of provider data
Ribbon CEO Nate Maslak said it best: provider data isn’t exactly the first topic that comes up at a dinner party. Lucky for us, Nate recently joined the Becker’s Healthcare Podcast with two industry experts who have a long history of working with provider data at health plans.
Dan Rosenthal is currently an advisory partner with Andreessen Horowitz’s bio and health fund and brings 21 years of experience at UnitedHealthcare to the conversation as the former CEO West and President of UnitedHealth Networks. Dr. Manish Oza, an emergency room physician by training, served at Anthem Blue Cross Blue Shield for almost 13 years and is now with Amazon Web Services as the Physician Lead for Clinical Strategy.
During the episode, these leaders dig into how provider data affects stakeholders across the industry, where health plans should invest in innovation, and their vision for the future of provider data.
Five takeaways for health plans
- It’s about more than the directory. “A health plan’s provider data management processes have a really big impact in terms of consumer satisfaction and outcomes,” Dan shared. “Provider data doesn't just impact the directory, but it also has important downstream implications on other really important workflows like claim processing, contracting, credentialing, network design - sort of the backbone of the network all relies on provider data.”
- Messy provider data drains operational resources. With 81% of entries in the 5 largest payer directories being inaccurate, plans are devoting significant resources towards solving this challenge. Dan explained, “From an operational cost perspective, provider data is a big burden to manage. It comes in so many different formats, it's often inaccurate. It's missing data fields. And so it's a really big lift to try to figure out, how do you get it better?”
- Without robust provider data, value-based care is difficult to deliver. As health plans develop high-performing networks, the ability to bubble up providers and facilities in value-based risk contracts will be critical. Dr. Oza argued, “We're going to have to get a little bit more sophisticated with provider directories. Payers are going to have to make it more advantageous to steer members to certain providers if that's their ultimate goal.”
- Investment in technology and innovation is key to meeting member needs. “When it comes to streamlining manual processes… provider data is the poster child for that,” Dan said. “Most health plans are not built in the same way as a data company. And so it's important if you're a health plan, that you look for a partner that has expertise as a data company.”
- Consumers care about shopping for care. Consumers are getting more educated and have a much higher bar for what they’re looking for, which pushes the system to deliver a better member experience. Dr. Oza added that people care about three main factors when choosing a health plan, underscoring the need to ensure provider data is up-to-date, “‘Is my doctor in-network?’ is most important. Second is, ‘Are my medications and/or drugs covered?’ And then third, ‘What’s my out-of-pocket cost?’”
Listen to the full episode, “The Future of Provider Data” on the Becker’s Healthcare Podcast. To learn more about Ribbon Health’s leading Provider Data Management solution, get in touch with our team below.