Transforming Provider Experiences: Navigating the Journey with Confidence

(4 of 4)

(In this fourth and final installment of our series on Provider Experiences, we focus on using provider feedback to continually innovate.)   

Providers’ needs are constantly evolving, and Medicaid agencies must adapt their systems and processes accordingly. Advanced analytics and self-service tools create a feedback loop that helps translate insights into innovation. For example, analysis of calls interacting with a secure AI-powered conversational voicebot or chatbot can help organizations understand inquiry types and transfer points. This data informs them of opportunities to expand self-service capabilities or improve the system, ensuring members and providers get what they need faster and easier.

Engaging Providers in the Product Development Process

The best experiences are created when providers are invited into the development process. It is recommended that vendor partners employ various strategies to engage providers at this stage, including hosting provider user groups and continually involving providers and state leaders in the iterative process. This collaboration enables providers to practice at the top of their licenses.

Innovation and Service: The Foundation of Exceptional Provider Experiences

Innovation and service are foundational to exceptional provider experiences. Vendors or agency departments that offer white glove approaches deliver continuous support through technology-enabled interactions and personal, in-office assistance, identifying opportunities to reduce administrative complexity for providers and staff.

For instance, centralized credentialing can reduce the administrative burden on providers by replacing the separate credentialing processes for each Medicaid MCO with a single credentialing process for the entire state. Vastly reducing the burden on providers erases a significant barrier to entry that causes network adequacy issues and is a source of provider frustration. Nor does this centralized process need to end at state boundaries; regional (and even national) credentialing can allow states to significantly reduce expenses by sharing cost and particularly benefits providers and beneficiaries near state borders.

Reducing Complexity, Improving Lives

Medicaid providers are driven by the desire to positively impact their communities. They shouldn’t have to choose between this commitment and the administrative burden of participating in the Medicaid program. Advances in technology and ways of working have made processing claims reliable and like-real-time, and the provider experience is on the brink of a similar reinvention.

The Path Forward

To drive change, state Medicaid agencies need intelligent provider solutions, human-centered design, and feedback loops that account for providers’ shifting needs. The moment has arrived. Agencies have the motivation to embrace this innovation, and industry-leading tools, technologies, and approaches provide the way.

Creating a Best-in-Class Provider Experience with Gainwell

A streamlined provider experience is best achieved by eliminating bureaucratic obstacles, leveraging CMS enrollments and data, implementing a prior authorization gold card process, and enhancing technological and operational efficiencies.

Improving provider experiences is about making thoughtful, strategic adjustments that address the entire journey. By focusing on these key strategies, agencies can create a more efficient, satisfying, and empowering experience for providers, ultimately leading to better outcomes for all. Read the previous installments on this series at gainwelltechnologies.com. For more information about frictionless provider experiences, read our white paper or contact us.