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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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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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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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Network Innovations Webinar with Aetna, Contigo Health, and Clarify

Clarify Health

Healthcare strategy and innovation leaders from Aetna, Contigo Health, and Clarify recently hosted a webinar discussion about innovations in provider network design and management to drive higher-value, more affordable, and more accessible care for members. I’m with Aetna, a CVS Health company. Keith: Wonderful. Thank you very much.

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Leading pharmaceutical benefit managers and management companies

Pharmaceutical Technology

Pharmaceutical benefit managers and management companies serve as intermediaries between insurance companies, pharmacies, and drug manufacturers. They bring together employers/plan sponsors, health insurers, plan members, drug wholesalers, pharmacies, and drug companies to facilitate better health outcomes at an affordable cost.

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

Clarify Health

How health insurance companies use outcomes data Outcomes data is more than just numbers; it’s a roadmap for continuous improvement and innovation. Leveraging outcomes data for quality improvement Payers can leverage outcomes data as a valuable tool to assess the quality of care provided by healthcare providers in their network.

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

Clarify Health

This increase can be attributed to many things, including an aging population, the increasing prevalence of chronic conditions, and greater access to care stemming from expanded insurance coverage. These patients have evolving and growing needs and expectations for the quality of care delivered and overall patient experience.

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