How CareJourney and Ribbon are partnering to bring provider cost and quality insights to the Find Care experience
March 27, 2023
Why shouldn’t patients benefit from the same provider-level quality insights available to healthcare payer and provider networking teams? Increasingly, they are - through partnerships like the one between CareJourney and Ribbon Health.
Organizations that help patients find care - be it through the referral process, through patient-facing “find care” experiences, or via telephonic care navigation and advocate services - are increasingly investing in analytics to select which provider will best serve a patient for better outcomes and lower costs. Ribbon and CareJourney’s partnership accelerates these investments into the “find care” experience.
For many years now, payers’ and other large healthcare institutions’ network teams have relied on increasingly sophisticated analytics about the cost-effectiveness and quality of providers. However, patients have rarely benefitted from these insights. Too often, patients (and those that help them find care) are left to sift through sparse and conflicting patient reviews, recommendations from friends and family, or equally uninformed (or worse, profit-motivated) referrals to choose where to get care.
The challenge has been that a broad constellation of data points and capabilities are needed to meaningfully support a find-care process that truly engages and informs the consumer. It’s next to impossible for one organization to tackle them all well. From foundational elements like the provider’s phone number, address, and specialty, to critical details like their areas of expertise or the insurances they accept… each of these elements represents a thorny challenge. Organizations tackling one piece of the puzzle almost inherently neglect another. Those that try to do everything often fail to move the needle in any area.
This is where Ribbon and CareJourney’s partnership presents a model out of the morass.
CareJourney is a leader in provider cost and quality analytics, serving many of the country’s leading ACOs, value-based providers, and innovative payers. Ribbon has become the go-to source for a comprehensive provider data platform that pulls together the broader constellation of data points and infrastructure needed for powering a meaningful find-care experience. Through our partnership, customers that help patients find care benefit from the “best of both worlds” - an accurate and dynamic provider directory plus leading insights on cost and quality… all via a flexible API infrastructure.
Leveraging these insights to match a patient with the right provider for their needs can have a significant impact on their care outcomes and medical costs. For example, partnering with and referring to high quality and affordable specialists can reduce inpatient admissions and result in potential savings of over $1,200 per patient.
At Ribbon, we’re thrilled to partner with market leaders like CareJourney for cost and quality insights. It would take years for us to replicate the depth of insights on provider cost and quality as the market leaders that have been in the industry for more than a decade, and our customers expect us to be focused on more foundational challenges - like getting the provider’s phone number and address right or building the infrastructure for intuitive search experiences.
Combined, Ribbon + CareJourney’s capabilities can support a high-value find-care process
One customer benefitting from the Ribbon and CareJourney partnership is Firefly Health - a payer and provider that has made it a point to build a better find-care experience for their members. On top of the data pitfalls described above, Firefly faced the other monumental challenges central to their business - providing top-notch care, administering benefits, ensuring affordability, building an engaging interaction model with their members, etc. Firefly partners with Ribbon for an evergreen provider dataset and the infrastructure to power a find-care experience, including CareJourney’s provider cost and quality insights.
Through this collaboration, Firefly is free to focus on what only they can do - bring the pieces together for the patient or member while ensuring cost and quality data is inserted into those key moments. In a recent Q&A with Ribbon’s team, Firefly’s Director of Operations Jane Zhu shared, “It's super important for us to send the patient to a doctor that's going to achieve high quality outcomes and be high value. When we became a health plan, it became even more important for us to look at cost and quality data.[...] Ultimately a big driver of a health plan’s success depends on whether or not we're able to navigate our members to that high quality, high value care.”
CareJourney’s Partnerships Lead Nik Kubasekspeaks to the value of the partnership: “At CareJourney we’re hyper-focused on clinical insights, which flow to all sorts of decisions from network construction to care model design to value-based contracting. But when it comes to helping patients find care, we know that cost and quality insights are just one piece of the puzzle. Through partnerships like the one with Ribbon Health, we can ensure our insights are making their way into patients' hands, and are paired with the other data elements needed to power their choices.”
Ribbon Health partners with innovators to transform how healthcare decisions are made. Ribbon's data platform fuels healthcare enterprises with actionable provider information, including insurance coverage, prices, and performance. With Ribbon, healthcare enterprises can empower people to make the most informed decisions about their care by finding trusted and affordable providers. To learn more about Ribbon Health's suite of solutions, visit www.ribbonhealth.com.
CareJourney, a health analytics firm, pairs cost and outcomes performance scores with national provider and group level benchmarking to educate organizations and equip them with critical analytics to make informed network and performance decisions.