Accuracy of Dermatologist Listings in Hawai‘i’s Medicaid (Med-QUEST) Physician Directories

Since 2017, Hawai'i has had a statute requiring health plans to update their provider directories at least monthly. However, the results of this study suggest that despite this regulation, errors in physician directories may be an ongoing problem. Using publicly available online Medicaid physician directories from Med-QUEST, Hawaii Medical Service Association (HMSA), AlohaCare, 'Ohana Health Plan, and United Healthcare, 473 unique listings for dermatologists were reviewed and 411 (86.9%) of these listings contained at least 1 inaccuracy. Using the deficiency scoring methodology designed by the Centers for Medicare & Medicaid Services (CMS), it was found that the proportions of deficient listings were significantly different among the directories (<i>P</i><.001). Med-QUEST had the highest weighted final deficiency score of 92.9% and HMSA had the lowest weighted final score of 49.2%. In between were United Healthcare (71.0%), 'Ohana Health Plan (69.7%), and AlohaCare (65.7%). It is unknown whether these results are an improvement from the implementation of the statute. Nevertheless, this issue can cause additional barriers for Medicaid patients who already experience narrower networks and longer wait times for dermatologists. Furthermore, it would also be worth investigating if this issue is also prevalent in listings for other specialties.

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Published
2025-01-10
DOI
https://doi.org/10.62547/uvii6313
Primary Topic
Healthcare cost, quality, practices
Type
article
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article

Accuracy of Dermatologist Listings in Hawai&#x2018;i&#x2019;s Medicaid (Med-QUEST) Physician Directories

Hannah Mettias, Amity Tran, Lee E Buenconsejo-Lum, John J. Chen et al.
Healthcare cost, quality, practices
article

Accuracy of Dermatologist Listings in Hawai&#x2018;i&#x2019;s Medicaid (Med-QUEST) Physician Directories

Hannah Mettias, Amity Tran, Lee E Buenconsejo-Lum, John J. Chen, Tiffany Ng, Devashri Prabhudesai, Lauren Nakamine
article en

Abstract

Since 2017, Hawai'i has had a statute requiring health plans to update their provider directories at least monthly. However, the results of this study suggest that despite this regulation, errors in physician directories may be an ongoing problem. Using publicly available online Medicaid physician directories from Med-QUEST, Hawaii Medical Service Association (HMSA), AlohaCare, 'Ohana Health Plan, and United Healthcare, 473 unique listings for dermatologists were reviewed and 411 (86.9%) of these listings contained at least 1 inaccuracy. Using the deficiency scoring methodology designed by the Centers for Medicare & Medicaid Services (CMS), it was found that the proportions of deficient listings were significantly different among the directories (<i>P</i><.001). Med-QUEST had the highest weighted final deficiency score of 92.9% and HMSA had the lowest weighted final score of 49.2%. In between were United Healthcare (71.0%), 'Ohana Health Plan (69.7%), and AlohaCare (65.7%). It is unknown whether these results are an improvement from the implementation of the statute. Nevertheless, this issue can cause additional barriers for Medicaid patients who already experience narrower networks and longer wait times for dermatologists. Furthermore, it would also be worth investigating if this issue is also prevalent in listings for other specialties.

Vol. 83(12)
University of Hawaiʻi at Mānoa (US)
Partnerships for the goals
Healthcare cost, quality, practices
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