As part of Baltimore-based Johns Hopkins Medicine, Johns Hopkins Health Plan leaders realized their physician colleagues are facing an “intense and inarguably growing” administrative burden, COO Ryan O’Donnell told Becker’s.
“When we realized we needed to up our game as a health plan by trying to reduce those administrative burden that come along with the day-to-day of providing care to our members, we realized there was a solution out there that helped us from a provider standpoint consolidate some of our touch points with them,” Mr. O’Donnell said.
The system’s multi-payer portal is designed to streamline the communication and coordination between payers and providers. Mr. O’Donnell sat down with Becker’s to explain how the portal came to be.
Deciding on a solution
The first step in the journey, Mr. O’Donnell said, was listening to physicians in practice settings large and small. Johns Hopkins Health Plan solicited feedback from physicians at Johns Hopkins and elsewhere in its network.
“Too often, we find ourselves, or other health plans, jump to solutions or respond too quickly to a demo, for example,” Mr. O’Donnell said. “So the first thing we did to identify this as a solution was to get really sound feedback from our provider partners.”
After landing on a multi-payer portal as the right solution, Johns Hopkins Health Plans settled on Availity Essentials to power the platform.
The implementation process took around nine months. Eligibility, benefits and claims payments were the first functionalities brought online, and single-sign-on points to make access easier were added later.
“Let’s say [physicians] are getting information about labs, or radiology that may require a third-party access,” he said. “We were able to bring in those touch points using single sign-on on the same portal, so they had a one-stop shop to get that work done all together.”
Seeking feedback
Feedback on the portal has been positive, Mr. O’Donnell said, in part because the portal reduces the learning curve of training on multiple systems.
“The providers have a lot on their plate. The administrative staff, the front office staff, the back office staff, is juggling a lot of different demands and competing priorities,” he said. “What they’ve said is, ‘It’s helpful to have one experience, one system, one username, one password to get a lot of work done.'”
The most common use for the portal so far has been electronic data interchange, Mr. O’Donnell said. The next step will be to add more static and dynamic reporting to the system.
“You can imagine examples where a provider might be in a value-based contract we have with them, or they’re in a special Medicaid incentive program and they want to check information about how they’re doing,” he said. “All that information, down the road, will be provided at their fingertips in the same portal.”
Creating a road map
Organizations that want to take on a similar project should be humble, listen and accept feedback, Mr. O’Donnell said.
“A lot of the time, that’s more common when it comes to the member experience,” he said. “We think it’s just as critical on the provider experience side.”
Any new tool or portal has to be part of a cohesive strategy to address administrative burden, Mr. O’Donnell said.
“Make sure you understand the use cases you’re solving for, and you equally understand the aspects of the relationships with providers you’re not solving for, so that you can be confident you’re going to have the ability to address those gaps through roadmap enhancements down the road,” he said.
