Health Equity and Social Determinants of Health (SDOH) have gotten more attention over the last several years, and rightfully so. As we’ve struggled through a global pandemic, people of color and low-income families have been disproportionately impacted according to a paper published by the Office of Human Services. The effects are not strictly economic. These communities have been impacted disproportionately in terms of physical and mental health as well as food security.
The industry itself is taking a closer look at how to address SDOH. This has led to numerous start-ups as well as established organizations taking measurable action to improve access to healthy food, transportation, and medical care.
With such a complex and challenging set of problems facing us, it’s worth looking at all the ways we can be part of the solution. One of the key things needed is clear, simple communication about the options available to help those in need. That includes how and where to find help. Let’s talk about the role of provider directories in helping to address SDOH.
The Common Provider Directory
Provider directories are a critical part of life at a health plan. Marketing and Sales teams use them to help members decide whether to enroll. They’re used during the enrollment process for members to select an in-network PCP. Utilization Management teams leverage them for referrals and authorizations. The No Surprises Act has now tied provider directory accuracy to a health plan’s financial incentives.
Provider directories generally need to include the most basic common sense elements.
- Provider Name & Demographics like gender and language(s) spoken
- Specialties
- Locations & Contact Information
- Plans Accepted by the Provider
These are generally considered to be a bare minimum. Many health plans may struggle to meet even these basics in terms of completeness and accuracy. Over time, other data elements have been introduced to provide better information to members or prospective members.
- Websites
- Wheelchair Accessibility
- Office Hours
- After Hours Availability
- Provider Ratings
Even in provider directories that include this information, it may be inconsistently collected and organized. It will likely always be a work in progress, a continual struggle to improve over time.
As we think about SDOH, though, what more could a provider directory tell us? Let’s take a creative look at some things we could do to make our provider directories more helpful to our members.
The Future of the Provider Directory
We can envision the future of the provider directory by starting with the communities we serve. These include ethnic and racial groups as well as social groups such as the LGBTQ+ community. Each of these populations faces different challenges when it comes to receiving quality medical care. These can include distrust of medical providers or concerns for their own safety in seeking care.
A provider directory should ideally help a member find a provider that they feel they can trust. In order to do that, there are some things we can consider that may help make those decisions easier.
- Can we provide a picture of the provider?
- Has the provider and their team been specifically trained to work with certain communities, cultures, and populations?
- Does the provider designate their office as a safe space for LGBTQ+ patients?
- Is the office and staff setup to support visual and hearing impaired patients?
- Are domestic and child abuse protocols in place?
- Does the provider’s office have protocols in place to identify SDOH and support patients in addressing them?
- Will the provider’s office help coordinate transportation to and from appointments and pharmacy pickups?
- Are appointments available during non-standard hours, such as weekends? This can help low-income families who may work multiple jobs to get care without having to sacrifice important income.
Collecting and organizing this data is sure to be a challenge. Presenting the data in a user-friendly way that most members can quickly understand will also present its own challenges. Additionally, once we have these things in place, it will be important to work with sales agents, brokers, and customer service representatives to train them on how to educate members about these supports. But the ultimate result we would hope for is that members are able to find providers they trust who can also help them to address external barriers to living their healthiest and most fulfilling life.
What more can we do from the perspective of provider data management to support SDOH efforts? Feel free to leave your thoughts in the comments below.