Health plan care navigation: the power of first impressions

Stephanie St. Thomas
October 20, 2020

How easy is it to find care through your health plan’s website?

Finding care is the #1 reason consumers visit health plan websites. When that first touchpoint is easy and reliable, it leads to an ideal outcome for health plans: trust between the consumer, their plan, and the provider.

As health care becomes increasingly digital, first digital experiences with a health plan may involve one of many pathways:

  • visiting a health plan’s online provider directory
  • completing a telehealth visit and searching for a specialist
  • using an online symptom checker, then needing to find care
  • interacting with a health plan team member—such as a care navigator—during a traditional phone call that concludes with a referral

Health plans are in a unique position to guide consumers to high-quality, high-value care while delivering smooth online interactions and exceptional customer service. Finding care online should always begin on a positive note, with an interaction that’s helpful, informative, and efficient.

Necessity of reliable provider information

A health plan invests significant resources to attract each consumer to its website. Yet consumers rate these sites a -40% Net Promoter Score for usability. A poor experience searching for care can cancel out all that prior investment. Examples include when a consumer:

  • can’t find their preferred provider
  • can’t find a provider that’s conveniently located
  • receives confusing information
  • can’t find the right kind of care
  • sees information that’s clearly wrong

These frustrations result from pervasive problems with provider data. While health plans have spent significant resources to improve their provider directories, the underlying data is complex, and provider data constantly changes.

  • Audits by the Department of Health and Human Services found incorrect data in 48% of provider records within the National Plan and Provider Enumeration System (NPPES).
  • A 2019 study published in the American Journal of Managed Care found that Google was more accurate than Medicare Advantage plan provider directories.
When finding care becomes fast and intuitive

Many health plans have made commitments to clarity across their websites and other communications channels. Organizations are re-tooling online content and search functionality to reach people with different reading levels. Twenty percent of the U.S. population has low literacy skills, as defined by the U.S. Department of Education.

As part of these initiatives, health plans are considering how provider search functionality can be highly accurate and intuitive: a greater challenge in healthcare than other industries, because underlying data issues also need to be addressed.

But even when the data is correct, searching for that data has still been a painstaking experience. Plans are making changes to technology that led to poor user experiences, such as less-forgiving search experience (for example, search that couldn’t overcome typos or misspellings).

Ribbon Health: a solution for national provider directory, user-friendly search

Rather than building every search and data solution in-house, health plans are turning to Ribbon Health, a highly accurate, national provider data resource, delivered through flexible, modern APIs.

Ribbon can augment a health plan’s own data assets, while strengthening data quality and the search experience. We’ve built our data to support consumer-friendly search, and we deliver a fast, intuitive experience, at any scale:

  • Overcomes typos to guide the consumer to the right provider
  • User-friendly for all literacy levels, so a search for heart doctors leads to cardiologists
  • Nuanced and adept at recognizing multiple network affiliations, primary care options, and more, so the consumer can easily find in-network care

Because our data and search are available through modern APIs, it’s simple for a health plan to install care-finding capabilities wherever and however they are needed, throughout a digital experience. Both consumers visiting the plan website and the health plan’s internal staff can rely on consistent, clear information about the health plan’s in-network providers.

Learn more about how Ribbon Health works with health plans on the path to digital transformation.

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