Written by Joy Payne and Amanda Minimi, Aeroflow Health

This content has been reviewed for accuracy by Amanda Minimi, Director of Corporate Development for Aeroflow Health.

The terms “ghost networks” or “phantom networks” emerged during discussions of mental health parity at the start of COVID-19. Coined by Mike Evans, partner at K&L Gates and former Senate Finance Committee official, these terms captured the frustration of patients encountering inaccurate provider directories. What began as a mental health-specific issue has since broadened to acknowledge the wider problem of outdated directories and the need for regulatory action.

According to Yale Law & Policy Review, between 45% and 52% of provider directory listings had errors, with some individual plans having error rates as high as 98%. While it may seem straightforward that having providers who are no longer licensed or practicing in their field or unable to take on new patients is a problem, ghost networks can extend beyond that. Sometimes, directories are too broad and can overwhelm patients with options that do not actually provide the specific type of care they need. Additionally, some provider categories, such as lactation providers or language specifications, may be missing from the directory altogether. In short, there are many optimizations that need to be done in order to meet the needs of patients.

Ways To Improve Directories

Improving directories can be achieved by taking a holistic approach to a patient’s healthcare journey. By considering all of the possible points and barriers in the care continuum, we are able to ensure directories are user-friendly and that patients can easily find the information they need to make the informed decisions about their care. Improving provider directories is critical to ensure patients have access to the care they need when they need it. In order to do so, we should:

• Increase transparency: Health plans and all providers should provide clear and concise information to patients about the providers in their network, including their contact information, office hours, and specialties. Health plans should also provide real-time updates, inclusive of product and services specific information, to their provider directories to ensure they are accurate and up-to-date.
• Improve provider data collection: Health plans should improve their provider data collection processes to ensure they are collecting accurate and complete information about their network providers, including their availability and acceptance of new patients. This can be achieved through the use of automation and standardized data collection forms.
• Improve network contracting: Networks should not be reviewed by the provider type but should be reviewed by the product category or specialty. This review can be completed by holding network teams accountable through taxonomy code reporting. This can also help health plans better identify the types of providers they need to add to their network to meet patient needs.
• Deeply understand the patient journey: Patients should be encouraged to provide systematic feedback on their experiences with healthcare providers. Understanding how patients both initiate and continue their care allows us to design richer processes that help them coordinate the best courses of action. This feedback not only improves the accuracy of provider directories but also ensures they are designed with patients’ needs in mind. By engaging patients in this way, we can make it easier for them to find the appropriate care, ultimately enhancing their overall healthcare experience.
• Increase collaboration: Health plans, providers, and regulatory agencies should collaborate to improve the accuracy of provider directories. This can include sharing best practices, developing standards for data collection and reporting, and working together to develop innovative solutions to improve provider directories.

How Aeroflow’s Integrated Approach Provides A Solution

Since 2001, Aeroflow Health has been working closely with their health plan partners to collaborate and improve the communication and engagement between patients and their health insurance providers. Through an integrated care model, Aeroflow streamlines the patient care journey, seamlessly weaving in complementary benefits that patients often seek, thus eliminating confusion and fragmentation in their care.
Aeroflow’s integrated approach combines personalized patient care with a robust network of healthcare services and benefits. By coordinating with health plan partners, Aeroflow ensures that patients receive comprehensive support, from initial consultations to follow-up care, and access to additional services like medical equipment, home health solutions, and wellness programs. This holistic approach not only improves patient outcomes but also enhances overall satisfaction.

Aeroflow’s integrated care model aids in the ghost network frustrations by seamlessly displaying all services and providers that are in-network with various insurance plans, often down to the employer-group level. Patients can easily access benefits through their in-network providers, eliminating the frustration of encountering ghost networks. Additionally, Aeroflow maintains an active directory of providers who are currently accepting patients and available through their insurance. By keeping this directory up-to-date and transparent, Aeroflow guarantees that patients receive care from active, verified providers, enhancing both accessibility and trust in the healthcare system. By eliminating ghost networks and clearly communicating benefits, Aeroflow significantly improves patient satisfaction and health outcomes. Our dedication to patient-centered care and innovation, coupled with our seamless integration of additional benefits, distinguishes us as a trusted partner in healthcare, setting us apart from other DME providers in the market.

Provider directories are essential for ensuring that patients have access to quality healthcare services. The existence of ghost networks and other inaccuracies in provider directories can lead to significant problems for patients, including delayed treatment, frustration, and potentially negative health outcomes. While there are already laws and regulations in place to ensure the accuracy of provider directories, there is still much work to be done to improve the patient experience and address the shortcomings of current systems. This will require a collaborative effort between healthcare providers, insurance companies, and policymakers to find comprehensive solutions that prioritize patient engagement, enforce subspecialties, and prioritize accuracy and timeliness in updating provider directories. By addressing these challenges, we can help ensure that patients have access to the care they need and deserve.