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Improving provider directory accuracy: can machine-readable directories help?

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Machine-readable (MR) provider directories are not currently more accurate than conventional ones. However, MR technology and other initiatives show promise for improving the accuracy of health plan provider directories.

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Area of Science:

  • Health Services Research
  • Health Informatics
  • Healthcare Administration

Background:

  • Provider directories are crucial for health plan navigation but often contain inaccuracies.
  • Health insurance exchanges mandate machine-readable (MR) formats for provider directories, prompting an examination of their accuracy compared to conventional formats.

Purpose of the Study:

  • To assess the accuracy of health plan provider directories.
  • To compare the accuracy of machine-readable (MR) provider directories with conventional directories.
  • To evaluate the potential of MR formats to enhance future directory accuracy.

Main Methods:

  • A descriptive study design incorporating qualitative stakeholder interviews and quantitative analysis of provider data accuracy from multiple sources.
  • Provider data from four sources across five counties were aggregated and analyzed using text matching and phone verification.
  • Twenty-one stakeholders were interviewed to gather qualitative insights.

Main Results:

  • Widespread inaccuracies were found in provider information across all directory types examined.
  • Provider directory phone numbers showed higher concordance with Google data than with directories from the same health plans.
  • Qualitative analysis revealed stakeholder perceptions of directory inaccuracy, with those familiar with MR directories recognizing their advantages.

Conclusions:

  • Machine-readable (MR) provider directories currently do not exhibit greater accuracy than conventional directories.
  • MR technology holds significant potential for cost-effective improvements in provider directory data quality.
  • Ongoing state- and vendor-led initiatives offer promising avenues for correcting widespread provider directory inaccuracies.