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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 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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How to scale your network design process

Clarify Health

Ashley Tidd partners with payers and provider groups to help them utilize healthcare analytics to increase their competitive footprints in existing markets and expand into new markets as quickly and efficiently as possible. Video transcript: The traditional process for designing and optimizing provider networks is ripe for innovation.

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Innovating the network design process

Clarify Health

Network design is of central importance to health plans. An efficient and effective network must be competitive to attract members and retain them by meeting their needs with high-value providers. One large national health plan had identified Medicare Advantage (MA) as a key growth sector and was looking to expand into 12 new markets.

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How TPAs Can Use Network Design as a Competitive Advantage

Clarify Health

With deep expertise in the healthcare and insurance fields and in-depth knowledge of industry standards, laws, and regulations, they can help businesses plan health benefits, streamline processes, and manage costs. The TPA market is expected to grow at a compound annual growth rate of 9.6% Healthcare isn’t one size fits all.

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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. Payers are responding by creating, acquiring or fortifying provider networks and healthcare clinics of their own.