How provider data can power more personal and accurate guidance for members resulting in better outcomes, at lower costs
Directing members to care is a foundational aspect of effective care navigation, and involves guiding members on a path to care that meets their specific needs and is within their network. Yet without access to a single source of accurate and comprehensive information on providers, these recommendations can quickly take a wrong turn - leading members to dead ends or destinations that don’t match their care needs. Members are left with frustration and delays in accessing important care. As the demand for employer and consumer care navigation grows, it’s critical for care navigation platforms to power their tools and navigators with a scalable and efficient solution for actionable provider data.
In order to prove value to customers, care navigation companies must demonstrate that members are able to easily access cost-effective and high quality care because of their platform. Ensuring a seamless and connected member experience not only supports better health outcomes, it reduces costs for customers such as employers. Employers want to see high engagement rates with care navigation tools, and as a result, lower their medical spend. If members can rely on a personalized and user-friendly product that they trust, they’re more likely to utilize their benefits and seek out preventative care. When members are guided to the right provider on the first try (i.e. one that is in-network, treats their specific condition, and has high quality and satisfaction ratings) they avoid headaches like surprise bills and unnecessary appointments or procedures, which rack up costs for both members and their employers.
Guiding Members to the Right Provider Reduces Cost of Care
Preventative care leads to improved health outcomes at a lower cost, and care navigation teams and platforms are often expected to identify high-risk, high-cost members and guide them to the right providers for their needs. This is a critical component of lowering costs for employers and other constituents, but challenges with inaccurate or missing provider data results in:
- Members being sent out-of-network or to the wrong specialist, resulting in unnecessary bills
- Member confusion, frustration and delays in care
- Member churn on care navigation platforms from dissatisfaction
Often, care navigation platforms rely on overly complex or manual processes to populate provider information and relevant fields. A key question becomes - how accurate and actionable is the information powering these tools? How often is that information updated? How often is the information validated and enhanced?
Ribbon offers a comprehensive provider data platform including essential provider performance data on cost and quality metrics to enable accurate, personal, high-quality referrals that support a positive navigation experience and reduce costs for employers. Using Ribbon data, care navigation partners have been shown to:
- Reduce time spent per referral by up to 80%
- Increase the number of quality referrals per day by about 3x
- Achieve a 99% average post-visit Customer Satisfaction Score
Ribbon’s data platform helps get people to the right doctors the first time. Members are able to easily access high-quality, in-network care, and care navigation companies can deliver on cost savings for their customers. Our comprehensive provider data solution offers accurate and detailed data across contact information, accepted insurance networks, cost, quality, specialties and more to enhance your tool and help you stand out in a competitive market. Ribbon’s API easily integrates into your existing workflows so that you can immediately start to surface relevant and reliable information - our data is constantly updated and enhanced by the network effects of our partners. Our dedicated team of deployment specialists and engineers provide ongoing support and partner with your team to drive the biggest impact for your business.
Learn more about how Ribbon uses data to simplify provider referral management for care navigators and members alike.