CAPG lauds report on Provider Director Accuracy, SB 137 implementation in California
CAPG President and CEO Donald H. Crane issued the following statement on the report Directory Assistance: Maintaining Reliable Directories for Health Plan Shoppers released by the California HealthCare Foundation (CHCF) and Manatt Health Solutions:
“CAPG commends the California HealthCare Foundation and Manatt Health Solutions for their detailed report, including examples from other states, to inform California policy on the topic of more accurate provider directories. Capitated and delegated medical groups in California strongly support increased accuracy in provider directories, which benefit patients, payers, and providers alike.
“The report points out that the state must consider how to accomplish this goal efficiently, and recommends a single electronic portal for all stakeholders. This system would both enable busy physicians to more easily update their status and provide up-to-date information on insurer provider networks to payers and patients.
“CAPG has urged the Department of Managed Health Care (DMHC) to consider using its undertaking process in the pending four “mega mergers” of California health plans to fund such a unified, online physician directory.
“The need for a single portal arises from the complicated logistics of implementing SB 137 next year. Individual physicians will receive files with hundreds of provider network listings from health insurers with whom they contract beginning July, 2016 and will have just 30 days to review and verify the information. Some physicians in small independent practice may be hit with over a thousand network filings, since they typically contract with dozens of individual health plans.
“Because of these challenges, CAPG urges policymakers to adopt the CHCF-Manatt recommendation for streamlining and automating the updating process. Enabling individual physicians and groups to go online and verify this information once for all contracted health plans will free up their time to focus on patient care.”
CAPG is the nation’s leading professional association representing physician organizations delivering capitated, clinically integrated health services. The organization’s 190-plus member groups—located in 39 states, the District of Columbia, and Puerto Rico—are committed to providing high-quality, affordable healthcare for all populations. To learn more, visit capg.org.