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Network Optimization Strategies for Payers: A Look at Provider Network Adequacy

Clarify Health

A well-balanced and adequately resourced provider network is a strategic asset for payers in the highly competitive healthcare insurance market. When looking to optimize, it is critical to ensure network adequacy or the provider network’s ability to meet the healthcare needs of an insured population.

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Three Strategies to Optimize Healthcare Provider Networks in New and Existing Markets

Clarify Health

Optimizing provider networks is the number one way to do so. Provider networks are the primary tool for health plans to attract and retain new members while optimizing returns. This makes network design a key factor in any member retention strategy. Payers are constantly looking to improve member outcomes while lowering costs.

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Clarify Health and Ideon Partner to Build Stronger, More Competitive Health Plan Networks

Clarify Health

Clarify Health is leveraging Ideon, the industry’s most accurate and comprehensive provider-network data solution, to improve health plan management, lower costs and promote high-quality healthcare. Health plans can use this intelligence to expedite their decision-making processes for network modeling and optimization.

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Do healthcare mergers and acquisitions lead to better care for patients?

Clarify Health

Today’s healthcare providers are seeing significantly more patients than they did a decade ago – many of whom are often sicker and have more complex care needs. But consolidation in healthcare markets is not with its critics, with some experts raising concerns over increasing prices due to decreased competition and eliminating services.

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How retailers and “payviders” are disrupting U.S. healthcare in 2024

Clarivate

Strategy #1: innovate and create Amazon founder Jeff Bezos has said that overnight success takes about 10 years — and that ramp-up period may be what’s playing out for the ecommerce giant in healthcare. billion, following an earlier failed healthcare venture with Berkshire Hathaway and JPMorgan Chase.

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U.S. market access landscape: A push for control is erasing the boundary between payers and providers in U.S. healthcare

Clarivate

healthcare payers and providers are consolidating at a dizzying clip as they seek to gain market share, increase access to care and secure clinical control to improve health outcomes. Vertical integration is common in the health systems sector.

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How payers can use outcomes data to enhance care and member experience

Clarify Health

In today’s healthcare landscape, outcomes data has emerged as an essential instrument in assessing the quality and effectiveness of healthcare services. Outcomes data is crucial for payers, as it serves as a critical tool in evaluating the quality and effectiveness of healthcare services.