High Value Health Care

Frustrated trying to pick doctors in your health plan network?

It's not easy finding a doctor in your health plan network. Changes might be coming. Give your input.

Health care

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If you have insurance, you know one of the most frustrating things is finding a doctor in your insurance plan’s network. Too often network directories (digital and printed ones) are inaccurate and out-of-date: the provider is no longer in-network or they aren’t taking new patients. You might see a photo and address, but what about their office hours or other doctors in their practice? 

We’ve got an opportunity to change this tool. The federal Centers for Medicaid & Medicare Services (CMS) is considering a first-of-its-kind national directory of health care providers and services. Now is your chance to express your frustrations using provider directories for your insurance plan and tell them the information you want to see. CMS has asked for public feedback

The directory, as envisioned by CMS, would be called the National Directory of Healthcare Providers and Services (NDH). This idea is part of the federal government’s efforts to improve access to care and support the exchange of information throughout the health sector. 

A tool this comprehensive doesn’t exist.

Current directories are health plan-specific and often don’t contain reliably accurate information about which plans each provider participates in or other useful information. With one central directory, patients could see all of the health plans in which they participate – making choosing a new health plan easier if you want to keep your physician. And doctors themselves would spend less time updating their information in dozens of different directories in order to keep patients informed. A national directory would create a single, centralized system. 

CMS is seeking feedback on whether you think of the overall concept and what information would be helpful to include. We think this centralized database might be more accurate and could be a source of other key information patients need when choosing a provider. We’ll be recommending that the directory include information such as whether providers are taking new patients and details about provider evening and weekend office hours. 

What else would you like to see in a centralized database of providers? 

The public is invited to send in their thoughts about establishing a centralized physician insurance network directory. What problems have you encountered with provider directories? Ask the CMS to address those problems. It’s easy to send your ideas – and it’s  important that you do.  Use this link, then click on the green button “Submit a formal comment.” The deadline is December 6, 2022.

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