HANOVER, MD – The No Surprises Act created transparency for patients and protection against unexpected billing, but it also brought new compliance requirements that left many health plans scrambling.

By adopting InsightPro from MDI NetworX, Johns Hopkins Health Plans (JHHP) has significantly streamlined operations and ensured member-focused compliance with the No Surprises Act.

“We are committed to providing the best possible health care experience for our members,” said Ryan O'Donnell, Chief Operating Officer for Johns Hopkins Health Plans. “Using innovative technology ensures that our members have access to accurate, up-to-date provider information, simplifying their care journey and promoting trust in our services.”

Powered by AI, the analytics platform has already yielded significant benefits for Johns Hopkins Health Plans, including:

• No Surprises Act Compliance: Ensured timely updates to provider directories, resulting in improved transparency for patients and minimizing billing confusion.
• AI-Driven Insights: Provided robust progress tracking and quality assurance capabilities to limit errors in directory listings.
• Reduced Appeals and Member Grievances: Decreased claims showing incorrect member cost-shares, promoting a smoother member experience and reducing member and provider abrasion.

“As a managed care organization administering government programs, compliance with laws and regulations is critical,” said John Wells, Executive Director of Compliance for Johns Hopkins Health Plans. “Technology that reduces errors and improves quality assurance makes us stronger for those we serve.” Since implementing InsightPro, JHHP has significantly streamlined operations and ensured patient-focused compliance with the No Surprises Act.

About Johns Hopkins Health Plans

As a part of Johns Hopkins Medicine, Johns Hopkins Health Plans administers a range of physician-sponsored health plans managing more than $3 billion in annual premiums and serving nearly 500,000 members. Johns Hopkins Health Plans’ robust network of providers includes Johns Hopkins Medicine physicians and providers, regional clinics and many other top-tier providers. Johns Hopkins Health Plans administers the US Family Health Plan for active-duty family members, military retirees and their families, Employer Health Programs, Priority Partners (Maryland’s largest Medicaid plan with co-owner Maryland Community Health System) and Advantage MD Medicare Advantage plans. It advocates for its members and fosters collaboration with providers to help achieve optimal health. Through its Johns Hopkins HealthCare Solutions business, Johns Hopkins Health Plans also offers the world’s leading population health analytics software, the Johns Hopkins ACG® System, used by commercial and government health entities and employers worldwide. Learn more at hopkinshealthplans.org.