Table of Contents
IDC PlanScape Figure
Figure: IDC PlanScape: Directory Accuracy and Network Adequacy
Why Is Directory Accuracy and Network Adequacy Important?
Mandated Compliance Demanding Frequent Outreach/Validation: With Specific Mandatory Directory Fields and Minimum Network Adequacy Requirements
Address the National Tide
Retain the Payer’s Ability to Narrow Networks by Being Transparent with Network Adequacy to Legislators and Regulators
Be Ready for Increased Network Adequacy and Directory Quality Audits
Differentiate the Brand: Address Consumer Engagement Desires
Set the Table for Telemedicine/Virtual Care Network Design Alternatives and Changes to Network Adequacy Variables
Network Design Changing
Network Adequacy Variables Changing
What Is Directory Accuracy and Network Adequacy?
Provide Current, Accurate Online, Electronic, and Paper Directories to Consumers
Comply with Federal, State, and Industry Mandates in This Area
Demonstrate Network Adequacy to Legislators and Regulators
Optimize Administrative Cost Addressing These Requirements
How Bad Is the Problem?
Why Is There a Problem?
Who Are the Key Stakeholders?
How Can My Organization Take Advantage of Directory Accuracy and Network Adequacy?
Tier the Provider Data: Determine Data Tiers and the Costs of Data Quality, Separate Core Directory Data from Core Operational Data and from Quality-Would-Be-Nice-to-Have Data
For the Directory Data, Adopt a Collective Noncompetitive Mindset: Is This Data Really a Competitive Advantage? Is It Worth the Cost of Doing It Alone?
Use a Strong Data Model and Data Architecture Ensuring One System of Record
Execute a Comprehensive Baseline, Reactive, and Proactive Approach to Maintaining the Provider Data Ecosystem