A better source of truth: Accurate provider data for physician recruitment cuts costs and improves outreach

A major multi-hospital health system based in Texas is one of the biggest in the United States. It is an $8 billion company that provides full-range, inpatient, outpatient, rehabilitation and emergency medical services through 48 hospitals and more than 1,000 patient access points. The organization serves a major metropolitan market, which has over 7 million people and 10,000 doctors. It is one of several health systems in that region competing for physicians and members.

For years, the health system had relied on data from the state medical license board to identify physicians, but it had shortcomings. The data was only updated when new physicians got their license and existing physicians renewed their license. Maintaining the dynamic universe of provider data is a difficult, but critical task for hospitals and health systems. Fifty percent of provider data is outdated after just 18 months. Provider information fuels many functions of everyday business, including provider directories, physician recruitment, claims processing, network management, compliance, fraud detection and communication between healthcare practitioners and the hospital. When provider data is accurate, these operations proceed smoothly. When they don’t work as they should, the impact of errors and missing information can be felt throughout the system. Without proactive management, thorough attentiveness and the right technology, the quality of an organization’s provider information diminishes quickly. The result is operating inefficiencies and sub-optimal networks that cost healthcare providers hundreds of thousands, and potentially millions of dollars each year. For the health system, that meant, in a market where physicians move often, much of the contact information in the medical license board database was outdated. The data couldn’t be trusted, which created multiple problems across the organization such as: Manpower needs couldn’t be assessed, Promoting CME events was too costly, and Promotional announcements weren’t getting through.

After researching numerous data companies, the health system selected LexisNexis® Heath Care and purchased the rights to its Provider Data MasterFile. A proven solution, it provides a more accurate data coverage solution with over 8.5 million U.S. healthcare practitioners and 1 million organizations. Provider Data MasterFile enables healthcare organizations to seamlessly integrate comprehensive provider information into their existing workflow and understand provider relationships across IDNs, ACOs, payers and healthcare systems. Using Provider Data MasterFile, the health system was better able to manage physician manpower planning. “We could then look at our market, see the volume of patients and determine which physicians were closest to those populations. We could identify not only our physicians but all physicians in the market. MasterFile gave us the ability to make data-driven decisions with confidence because we could trust the data.” Provider Data MasterFile also made finding healthcare-related service providers easier. “When we had a patient who required follow-up care, we previously relied on Google,” the Director explained. “We were aware that wasn’t the best solution. Now we can find service providers in MasterFile. It gives us the means to better ensure a continuum of care for our patients.” The Director said another unanticipated benefit has been access to the National Physician Identifier (NPI) in Provider Data MasterFile. NPIs are a unique 10-digit number given to each physician. The state licensing board data that they had been using did not include NPIs, which created confusion when multiple doctors had the same name or were inconsistent in the use of middle names versus middle initials, and suffixes like junior and senior. “With NPIs we can be 100% sure we’ve identified the right Dr. Smith, and that all of Dr. Smith’s relevant data—specialty, license, facility, practice location, etc.—has been correctly attributed. It saves time and reduces risk,” said the Director.

• Using Provider Data MasterFile, the health system was better able to manage physician manpower planning. They could look at their market, see the volume of patients, and determine which physicians were closest to those populations. This allowed them to identify not only their physicians but all physicians in the market, enabling data-driven decisions with confidence.
• Provider Data MasterFile also made finding healthcare-related service providers easier. Previously, they relied on Google, which was not the best solution. Now, they can find service providers in MasterFile, ensuring a better continuum of care for patients.
• Another unanticipated benefit has been access to the National Physician Identifier (NPI) in Provider Data MasterFile. NPIs are a unique 10-digit number given to each physician. The state licensing board data they had been using did not include NPIs, which created confusion when multiple doctors had the same name or were inconsistent in the use of middle names versus middle initials, and suffixes like junior and senior. With NPIs, they can be 100% sure they’ve identified the right physician, saving time and reducing risk.

• The health system is an $8 billion company.
• Provider Data MasterFile provides data coverage for over 8.5 million U.S. healthcare practitioners and 1 million organizations.
• Fifty percent of provider data is outdated after just 18 months.