Ribbon Health finds individual health plan provider directory accuracy under 50%

Nate Maslak
January 31, 2020
In the fall of 2018, Ribbon Health conducted a study of provider directory accuracy insurance plans on individual exchange marketplaces (e.g., healthcare.gov, state exchanges, private exchanges).

The Ribbon Health study demonstrated that provider directories for these individual exchange plans are under 50% accurate. Further, we found that Ribbon Health predictive analytics drove a lift of over 30% across the board for these plans. These findings are consistent with the Centers for Medicare and Medicaid Services (CMS) audits of provider directories for Medicare Advantage, which found that 45% of all provider directory locations were inaccurate.

Health plan directories for individual marketplaces are under 50% accurate, but Ribbon Health predictive analytics can help.
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We at Ribbon maintain that inaccurate provider directories are one of the biggest barriers to access to care that exists in our current system. Inaccurate information on medical professionals prevents patients for finding physicians, adds undue administrative burden on physicians, and drives costly fines and poor member satisfaction for health insurers.

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