California payers, providers, and regulators are working together to improve data sharing

California payers, providers, and regulators are working together to improve data sharing

Accurate and current data is critical in the healthcare industry. Patient data as well as provider data must be properly maintained to ensure the quality of healthcare services. In particular, physician data has to be easily accessible and has to have the correct information for patients who are searching for a provider and for providers who need to connect with each other when coordinating services.

Unfortunately, given a number of factors, physician data is not always accurate or current. Healthcare payers may change their list of providers who are considered in-network. Physicians may change locations or employers, information that has to be updated with every appropriate healthcare payer. Providers may even venture into a new specialty area. These changes are not always reflected in available provider data. It is estimated that over half of all data found in provider directories is inaccurate.

In California, however, a new centralized online provider directory is changing all of that. Integrated Healthcare Association (IHA) has launched a new service, the Symphony Provider Directory, formerly known as the California Provider Directory Utility (PDU). The new directory, funded by a $50 million grant from Blue Shield of California, will serve “as a platform for plans and providers to exchange and reconcile provider information, resulting in improved data quality and more efficient processes.”

The new service is the result of a “cross-industry collaboration of plans, providers, purchasers and regulators.” The directory “enables health plans to maintain more up-to-date and accurate information such as provider demographics, panel status and health plan product and network details in their consumer-facing directories so that consumers can make informed decisions about their coverage and care.”

Jeffrey Rideout, M.D, President and CEO of IHA, notes that the Symphony Provider Directory is “much more than a complex IT project. This is an industry-wide commitment to improve the healthcare system in California. IHA’s role is to drive alignment and establish an effective and sustainable platform that supports the complex needs of health plans, providers and ultimately healthcare consumers.”