MHBE Provider Directory A service of Maryland Health Benefit Exchange
Background The MHBE Provider Directory helps consumers identify the providers that participate in QHPs and Medicaid MCOs – Developed in 2013 and maintained by CRISP, Maryland’s Health Information Exchange – Averaged over 650 users per day during OE3 2
Background Consumer Sites CRISP Provider Search CRISP (biweekly unified Provider output files) Data Processing Optum PDM and P360 (data standardizing, matching, and de-duplicating) Data Provider QHP and MCO Submission Error provider Files Corrections 3
Background Provider Directory funded in FY2016 through MOU with Maryland Health Care Commission (MHCC) – Leverages MHCC’s expertise to provide oversight and ensure CRISP performance More robust provider directory platform will be developed for Integrated Care Network – Will be designed to meet needs of multiple stakeholders – Cost to develop and maintain would be shared by multiple stakeholders HB1318 prohibits the MHBE Board from setting standards on carrier provider directories until 2019. 4
FY 2017 Proposal FY 2017 budgeted amount is $265,000 total funds ($151,050 state funds) Proposed NTE is $251,526 total funds (143,370 state funds) Continue to fund through MOU with MHCC Proposed MOU includes the following services: CRISP Service Annual Cost PDM (Optum) - Core Processing $138,000 P360 (Optum) - Data Cleansing $39,900 Hosting at Amazon $8,760 Project Management / Operations $42,000 Overheads $22,866 Total $251,526 5
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