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

Clarify Health

It empowers decision-makers to craft strategies for coverage, pricing, and provider partnerships that better serve both patients and profitability. By analyzing patient outcomes, health plans can assess the value of the care being provided and make informed decisions about coverage, pricing, and provider partnerships.

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Powering network negotiations with on-demand rate intelligence for providers

Clarify Health

In January 2021, the Healthcare Price Transparency Act went into effect, requiring hospitals to publish their cash pay rates and rates negotiated with health insurance companies. Moreover, health plans will be utilizing the increased pricing and performance insights for network design and negotiations.