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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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Value-based healthcare can help reduce costs

World of DTC Marketing

According to the Kaiser Family Foundation (KFF), in 2021, the average cost of employee health insurance premiums for family coverage increased by 4% from the previous year to $22,221. Why haven’t more employers addressed the rising costs of employee healthcare with value-based care? health care system.

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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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How TPAs Can Use Network Design as a Competitive Advantage

Clarify Health

Finding and maintaining affordable healthcare plans is challenging for businesses that lack the expertise and resources to navigate a complicated landscape. That’s why organizations are turning to third-party administrators (TPAs), licensed entities that help administer healthcare benefits for self-funded plans.

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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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Healthcare is about profits, not patients

World of DTC Marketing

Some are also increasing their profit margins by forcing out healthcare staff who have seniority and earn more. One of the best ways is to cut costs which means letting experienced healthcare workers go. Still, older healthcare employees who are at the top of the earnings schedule are being forced out. Changes are imminent.

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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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