One of the main reasons why access to health care is difficult


People are starting to come back to doctors, but access to care remains difficult. “Repressed requestIs the term used by industry experts as we come out of specialty care closures. Health systems are geared towards recovery – filling the schedules of electives.

Despite all that has changed about access to health care over the past year, one thing has unfortunately remained the same: the path to access to care.

Patients continue to depend on insurers and Google for care. They seek answers to these three main questions:

  1. Insurance: do they accept my plan?
  2. Location: are they close to my home or work?
  3. Reputation: What Are Patients Saying in Ratings and Reviews?

Finding answers to these essential questions is often difficult and frustrating. My own maddening journey to accessing healthcare began with a recent search for a doctor.

The digital front door is closed

I started like most consumers, with my insurance card. I am fortunate to have a fantastic PPO with the biggest payer in the country. In theory, I can get treatment anywhere. But, after failing to access the supplier list, I gave up and called the employer’s third-party administrator.

With a tone suggesting that she receives this request every day, the operator explained to me a series of clicks to find me on a separate website with the directory of physicians providing my plan. I was 30 minutes away from my task, but I finally came to the right place and started my search with enthusiasm.

Find a doctor (or at least try)

The payer’s “Find a Doctor” feature selected 66 doctors based on my search criteria, but had limited information – no photos, bios, ratings, and reviews. So I took the next step most consumers take in seeking access to health care: I Googled.

The first doctor appeared on Google My Business with a different address about 40 miles from what the insurance website said and labeled “Permanently closed.”

When I called the “closed” office number, a staff member explained to me that neither Google, nor the insurance website, nor their own website was correct. Instead, I got a Fourth address, which was not listed online. She also informed me of a new doctor with office hours near me. But, this provider did not show up as part of my networking options. Trying to reassure me, she explained to me that data from new suppliers was often missing and that she would continue to check for updates in the weeks to come.

I moved on to the next person on my insurance website shortlist. Again, Google showed a different location for the insurance directory. I sucked for three so far. Then a quick search and another “permanently closed” attribution on Google.

I tried very hard in finding access to health care. I am a qualified lead with great confidence. But after more than an hour of browsing five websites, three phone calls, and plenty of Google searches, I accepted defeat.

The data problem – and what to do about it

I’ve been foiled by disconnected provider data that healthcare systems and payers have yet to optimize at scale. This issue recently came to the attention of the San Diego City Attorney’s Office, which accused some vendors of exploiting “Ghost networks” that frustrate patients “with repeated and unsuccessful attempts to obtain coverage using inaccurate directories.” San Diego City Attorney’s Office Alleges payers violated a California law require insurance companies to maintain accurate and up-to-date supplier directories.

I have worked with many healthcare systems and payers, and I understand why the challenges exist. Disparate databases, accreditation systems and an overabundance of point solutions make it extremely difficult to manage supplier data, let alone disseminate it to consumers in a way they can digest. Based on my experience, I knew exactly where to look, and yet I arrived empty-handed. If it was that difficult for me, imagine how difficult it is for the average consumer to access care.

While the problem is complex, the solution is deceptively simple: data governance. Creating a “single source of truth” is the boring and thankless foundation upon which all marketing and patient experience efforts must be built. Manage all vendor data in one main hub, and everything else – your website, third-party listings, and payers – can pull straight from that source.

Healthcare providers face pressure from Google

Google is forcing the hand of health care when it comes to data, most recently around insurance transparency. Google My Business now has a attribute for “Insurance accepted” that appears on health care lists. If the brands do not manage this data, Google will automatically update the information by pulling the data from third-party sites. The message to healthcare is clear: own this data, or Google will do it for you.

Of all the research online, 65% of these will result in a conversion straight into the results page, which means the consumer will never even click on your website. Healthcare brands are investing huge sums of money in marketing campaigns, websites and apps that will never be effective until a consumer can overcome data barriers to accessing healthcare. Data is not a glamorous issue for healthcare executives. It doesn’t sound as interesting as “reimagining the consumer experience” or “clinical digital transformation” in a press release. But until the database is rebuilt, consumers will struggle to access care.

I’ll try my own research again tomorrow. But for now, demand will remain pent-up.

Photo: Alexei Naumov, Getty Images

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