A directory listing is not access to care.
Your behavioral health network looks adequate on paper. Whether a member can reach a provider who is accepting, takes their plan, and has an opening is a different question, and it is the one that determines whether they get care.
Counted providers are not available providers.
Network adequacy is usually measured from a directory. Members experience something else entirely.
Listings that cannot take patients
A provider counted in the network may have closed their panel, moved, or stopped taking the plan. The listing stays, and the member absorbs the difference.
Access measured by proxy
Distance and provider counts are measurable, so they get measured. Whether the member was seen is harder to observe, so it usually is not.
No visibility into the drop
When a member never starts care, there is rarely a record of where it broke down: acceptance, scheduling, or attendance.
Measure access by what actually happened.
HopeConnect produces this data as a by-product of coordinating the referral, not from a survey.
- Provider information maintained by providers. Each provider keeps a Passport with plans accepted, populations, care settings, and real availability, updated in one place rather than re-attested into a directory.
- Acceptance and attendance, observed. The lifecycle records accepted, scheduled, and seen, so access is measured on events rather than on listings.
- Where members drop out, by stage. Leakage is attributable to a stage, which tells you whether the problem is panel capacity, scheduling, or follow-through.
- Inferred data flagged, not assumed. Where a provider's plan participation was derived rather than stated, it is labeled and must be confirmed before sending.
- Turnaround as a real distribution. Time from referral to seen, measured across cases, rather than a target nobody can verify.
- Metrics withheld below a valid sample. The platform shows insufficient data rather than a figure that would not survive scrutiny.
On what a pilot can and cannot prove.
We are not going to claim regulatory compliance for you.
Network adequacy standards vary by state, line of business, and regulator, and they change. HopeConnect measures whether members referred through the network were accepted, scheduled, and seen, which is the underlying reality those standards are trying to approximate. Whether that evidence satisfies a specific requirement is a determination for your compliance and legal teams. We are pre-launch, we have not been through that review with a plan yet, and we will tell you what the data shows rather than what it proves.
Find out what your members actually experience.
Run a founding pilot and measure access on outcomes rather than on a directory.