From the Ground Up: Building a Provider Data Infrastructure

H1 Fuels Mending’s Innovative Insurance and Patient Care Model

While the common challenge that health plans face with provider data is that it gets messy and out-of-date as companies grow and systems become siloed, startup health plans face a very different problem: no provider data infrastructure at all. Building a data management infrastructure from scratch requires significant time and resources.

Mending, an innovative startup health plan serving Maine and Oklahoma, turned to H1 to power their “Find Care” tool. Core to Mending’s strategy is its Direct Primary Care model, which connects members to dedicated Primary Care Physicians for concierge-like, high-value care. Mending turned to H1 to help power its “Find Care” tool to identify relevant, in-network providers who also have direct relationships with Mending.

" Building all of this in-house would be really resource and cost-prohibitive. [H1] has built all of these pipelines for us, allowing us to focus on delivering a great product through a stable API."

Due to the lack of existing infrastructure, building a tool like this would require significant time and resources. H1 stepped in to develop these core capabilities, allowing Mending’s in-house teams to reallocate energy to other critical projects. H1 established an end-to end provider data management infrastructure to transform and enrich Mending’s existing network data into accurate, complete data critical to powering an effective provider search experience.

Provider Data Management for a Positive Member Experience

When Mending first started, they acquired a set of provider network data that included a base list of providers and their practice locations. However, the dataset lacked additional insights – like physician specialty – that are required to allow members to conduct precise searching and filtering.

Layering in this additional data brought the Mending team one step closer to helping their members find the right doctors. By working with H1, Mending has saved valuable time and resources and was able to focus on its core product strategy and execution that enhances the member experience.

Bringing Mending’s “Find Care” Tool to Life

For Mending, their “Find Care” tool is all about helping their members to “find great healthcare in their backyard.” For that to become a reality, the two datasets needed to be matched, de-duped, assigned unique identifiers, and – last but not least – tagged to ensure that the Primary Care Physicians and locations that Mending has direct relationships with will be surfaced first.

This transformation into an accurate and complete dataset was critical to powering an effective search experience. Mending’s Find Care tool is now a seamless platform for their members and providers to access. By surfacing their Direct Primary Care providers, they’ve been able to enable a value-based care model that offers a more personalized, coordinated, and cost-efficient experience for their members.

The Impact of H1’s Provider Data Management Infrastructure

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If you’re interested in learning more about how H1 supports both national health plans and startups who are building provider data from scratch, request a demo here. We can unlock impactful time, resources, and cost savings for your team.