Enhancing a Provider Sponsored Health Plan’s Digital Capabilities

The Challenge

The Provider Sponsored Health Plan faced increasing pressure to offer a modern digital experience, expand product offerings, and comply with federal transparency regulations (TiC/NSA). Their existing provider directory vendor could not meet these evolving needs. Challenges with the legacy directory solution included:

• Limited provider search and display functionality;
• Inability to support tiered networks and complex plan designs;
• No mechanism to promote health system-owned providers and facilities;
• Non-compliance with required price transparency mandates; and
• Absence of a robust provider data cleansing capability.

The Solution

After a thorough evaluation, the Health Plan selected Perspecta to replace the incumbent solution. The project involved:

• Collaborating with the Health Plan’s business and product teams to define key requirements;
• Deploying two distinct directories: a public-facing directory and a member-specific directory;
• Seamless integration of the member directory into the Health Plan’s portal using SSO;
• Incorporating advanced search features, tiered network logic, and branded interfaces; and
• Supporting compliant price transparency tools.

The Results

The Health Plan now benefits from improved provider search functionality and data presentation, increased referrals to in-system providers and facilities, greater flexibility in network design and product configuration, enhanced compliance with TiC/NSA price transparency mandates, and a future-ready platform positioned for growth and innovation.