Private Payers News

Blue Shield of CA to Offer Statewide Healthcare Provider Directory

Blue Shield of California has begun development on a statewide provider directory and will offer up-to-date information on physicians’ members.

Blue Shield of California to develop provider directory

Source: Thinkstock

By Thomas Beaton

- Blue Shield of California plans to develop a statewide healthcare provider directory, with the help of Integrated Healthcare Association (IHA), that gives members access to current information on providers, the payer announced in a press release.

The development of the directory is a response to the rising number of insured patients in California who have received coverage under the Affordable Care Act

Blue of California aims to uncomplicate the process of finding an in-network physician that is accepting new patients and improve provider transparency for consumers.

“Blue Shield of California is committed to transforming a fragmented and overly complex health care system into one that is worthy of our family and friends and sustainably affordable,” said Paul Markovich, President and CEO, Blue Shield of California.

“This includes working to bring health care into the digital age. A statewide provider directory utility will benefit consumers who rely on the accuracy of provider directories when making decisions about their health coverage and will reduce the administrative burden on health plans and providers,” Markovich added.

An advisory committee last year defined the priorities, functions, and governance requirements of the tool and determined that IHA was best suited to host the tool.

“We are excited to collaborate with Integrated Healthcare Association to advance this effort. IHA’s extensive experience and track record of launching and sustaining successful programs, commitment to a culture of collaboration, and ability to work closely with plans, providers, and other stakeholders, uniquely positions them for success in this much-needed endeavor,” Markovich said.

The collaboration will allow providers and payers to update key information that should create a better experience for beneficiaries. “IHA is thrilled to collaborate with Blue Shield of California in addressing one of the more vexing problems facing the healthcare industry,” said Jeff Rideout, MD, IHA President and CEO.

“IHA’s unique relationships with key stakeholders, data stewardship and passion for creating industry efficiencies positioned us well to develop a utility that will ensure end-users have access to accurate, reliable, complete and affordable provider directory data.”

The tool is another part of the Department of Managed Health Care’s (DMHC) agreement with Blue of California, under which the DMHC allowed the payer corporate acquisition of another plan toward statewide care improvements.

“Accurate provider directories are a basic element to consumers making informed health care decisions – from choosing the right health plan to accessing care once enrolled,” said DMHC Director Shelley Rouillard.

“It is imperative the entire industry be actively involved in a solution that improves accuracy and reduces the burden on consumers to find providers in their health plan network. The Statewide Provider Directory Utility is a first step in getting to that solution, and I want to thank both Blue Shield and IHA for their commitment to move this project forward.”