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How payers can use healthcare data to enhance network adequacy

Clarify Health

Designing and maintaining a healthcare network is no simple task—especially when it comes to meeting the needs for accessibility, quality, and cost across a diverse pool of members. Beyond supporting the health and well-being of its members, provider network adequacy is essential to a plan’s financial health and performance.

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How price transparency in healthcare will impact provider networks and patient choice

Clarify Health

Healthcare prices in the U.S. Varied health plan contracts and coverage made it nearly impossible for patients to know ahead of time what they’d be charged for a given service. Complying with the regulations won’t be enough for healthcare delivery organizations that want to thrive in this new, more transparent environment.

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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. These patients have evolving and growing needs and expectations for the quality of care delivered and overall patient experience.

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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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Unleashing the Power of Healthcare Data Analytics in Health Plan Network Design

Clarify Health

The transformative capacity of data analytics is shaping the future of healthcare, driving new levels of efficiency, effectiveness, and patient-centric care. The Role of Data Analytics in Health Plan Network Design In the context of health plan network design, data analytics offers the potential for a seismic shift in our approach.

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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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Building a Robust Provider Network with SDoH Insights

Clarify Health

When building provider networks, it is crucial to include providers who can assess and address social determinants to ensure that care is equitable, patient-centered, and effective in improving health outcomes and reducing healthcare disparities.