All About Provider Directories, Part I: The Who of Healthcare

One common thread between the various organizations we work with at Carevoyance, is that they all have to maintain their own directories of physician and facility partners, opportunities and contacts in order to stay competitive. Losing track of physicians as they move jobs, cities or even careers is a huge competitive and revenue exposure. Thus, accuracy of these directories is not only vital for patient outcomes (device service alerts, recalls), but also for marketing (new product launches, updates), and sales.

Inaccurate provider directories are not simply an inconvenience

For medical technology companies, inaccurate provider directories are not simply an inconvenience. Bad contact data is costly and wasteful, especially if your business depends on having physicians use your product.

In this series of posts, we'll go through the steps of helping one of our customers clean their physician data, automating a continuous quality process, and in doing so, improving patient safety, and saving time and money.

A customer's challenge becomes our opportunity

Solving difficult problems with data is our passion, so, when one of our customers came to us with a provider directory challenge, we were more than happy to dive in and help.

Our key account contact, Tim (names changed to protect the innocent), works for a large cardiac device manufacturer. After many years in the market his company had developed an impressive book of business, but a book that had stagnated over many years of job transitions, physician moves, new physicians finishing residency and a variety of other factors.

The business issue that brought Tim to us was immediate and acute. His company was finally ready to switch to Salesforce.com's CRM, but were worried about loading their old, crusty data into it. For good reason, too; many CRM projects fail because of fundamental data distrust. CRM users - field sales, support and marketing will quickly abandon a system built on old, unreliable data.

To help Tim with his problem, we had to invent all whole new way to store, manage, audit and merge data, and were able to help Tim reach a 99.2% match rate to his original mismatched data, while identifying new opportunities Tim's team didn't even know about, all along building internal tools (and eventually external ones) to help other customers like Tim get ahead of their provider data quality challenges.

Provider Directories underwrite the who of healthcare

Provider directories are white ​​pages for physicians. The most simples ones organize physicians by location, specialty, phone number, accepted healthcare plans and a host of other attributes. Their importance is not so much in what they say, but how accurate they are. 

Every medical technology company has at least one provider directory that it maintains. It may be a customer directory, a prospect list in your CRM, or the account list in your ERP (Enterprise Resource Planning software - Oracle ERP, SAP or Microsoft, usually). Bottom line, if you work with physicians, you have to keep their names, locations and other information up to date so you can do your job effectively, whether it's selling, marketing or supporting your company's growth.

Provider directories are mostly inaccurate, entirely inconsistent

Overall, of the 5,832 providers in the review, 46.9% (2,737) of providers had at least one deficiency. Of the 11,646 locations reviewed 45.1% (5,257) of the locations had at least one deficiency.

The above graphic illustrates the dire quality challenges of Medicare Advantage organizations when it comes to their physician data, with 46.9% of provider records found inaccurate or deficient. The accuracy issue isn’t limited to Medicare Advantage plans, though. The Office of the Inspector General (OIG) examined access to care in Medicaid Managed Care plans and found that 35% of the providers assessed “could not be found at the location listed by the plan.” Iowa’s Medicaid program has also come under attack over directory concerns, as well as Marketplace and commercial plans, which have seen their share of directory complaints.

Commercial challenges of bad provider data

Not only are provider directories woefully inaccurate, but it turns out, most CRM data is as well. In a recent study, inaccurate CRM prospect data cost on average 550 hours  (27.3% of seller time) per rep year. At an average annual salary of $157,000, the cost can be upwards of $43,000 per year in wasted time and effort!

At an average annual salary of $157,000, the cost of bad provider data can be upwards of $43,000 per year in wasted time and effort per sales representative

The challenge for medical technology companies is that they have to deal with two distinct problems: maintenance of both provider directories and CRM contacts.

Hopefully, by this point, you're interested in understanding more details, and so we'll continue in 2 weeks with initiating a provider data audit.

Up next, Part II: Data audit

In the next installment, I'll discuss the process Tim went through with Carevoyance to create a data audit to understand the quality issues in his company's provider directory.