As part of our commitment to our clients, we regularly monitor proposed and passed regulatory and compliance legislation that might impact their business. Not only does this allow us to help clients stay informed and navigate upcoming changes, but it becomes a contributing factor to our evaluation of enhancements to our product roadmap and solutions.
The most recent rulemaking became effective January 2024, when CMS added new print and online provider directory requirements applicable to Medicare Advantage (MA) plans. As new healthcare mandates tend to do, these changes impose additional regulatory burden on MA plan issuers. CMS has even acknowledged that the adoption of these new requirements may result in “increased provider burden and abrasion.” On the bright side, our internal review determined that Kyruus Health’s current solutions broadly support the functionality to meet the requirements.
In general, the ruling adds requirements that resonate with the core of Kyruus Healths’ mission to connect people to the right care:
- Supporting equitable patient access
- Improved continuity of care
- Usability of provider directories
More specifically, the provider directory requirements include a new “linguistic capabilities” attribute, broadens the search requirements across all elements, strengthens translation requirements, and mandates notifications when a provider leaves a network. While CMS rulemaking can sometimes be difficult to interpret and implement, we believe that it is our responsibility to help bridge disparities and improve patient outcomes as we strive to meet the needs of a growing and diversified population.
Our recent survey data highlights the importance of providing members with the best possible digital experiences:
- Of people who research their care option online, 58% of consumers first search for a provider on their health plan website—more than for any other online source
- Out of 79% of consumers who use their insurer’s healthcare transparency tools, 88% agree that the tools helped them make more informed decisions
Kyruus Health’s care access platform powers the provider directories for many of the nation’s leading healthcare organizations, and we don’t take that privilege lightly. We are committed to our clients and their members, helping people find the care they need by providing an accurate and transparent directory for consumers, while at the same time meeting any healthcare compliance requirements.
Reach out to learn more about how we can help your organization transform care access and delivery.
