A new report by CMS echoes many patients in criticizing Medicare Advantage (MA) online provider directories for containing too many errors. “Online Provider Directory Review Report” concludes that too often a directory entry is incorrect because the provider wasn’t at the listed location, the phone number was wrong, or the provider wasn’t accepting new patients although the directory said otherwise. According to the report, the average inaccuracy rate for provider location was 41.37%.
The survey followed the October 2014 publication in JAMA Dermatology of research indicating that 45.5% of dermatology listings in surveyed MA plans were duplicates in the same plan directory and that only 48.9% of dermatologists were reachable, accepted the listed plan, and offered an appointment for a fictitious patient. (But query, how often do fictitious patients have skin problems?)
The causes of the errors are easy to understand but hard to address. Typically, the directories contain information provided to the MA plans by providers. Increasingly, the information is provided by provider groups rather than individual providers. Groups often list each provider as located at all group locations, though a particular provider may actually see patients at only one or some of the group locations.
What’s more, it’s hard for directories to keep up with providers as they move from one group to another or one location to another, retire, or die. Dying is particularly problematic because providers often fail to give advance notice, and they can’t give it after the fact.