Payor Contracting

4 Mistakes Network Development Teams Make With Strategy

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Network development teams have to handle a lot of cross-talk, changing regulations, rotating personnel, and endless data streams to achieve a health plan’s growth goals. Only the most experienced teams are truly adept at expanding with high degrees of profitability and efficiency, as smaller plans or less-experienced teams simply don’t have the resources or knowledge to make the most out of each growth cycle.

Here are five ways to know if you might be making common mistakes that PayrHealth’s network development experts know how to correct.

1. Being Blindsided By Changes in the Market Landscape

With annual cycles of CMS policy updates, healthcare organizations follow a predictable path of receiving new information about the provider landscape, crafting a strategy, then executing it during the rest of the year. However, considering the competition for emerging markets and gaps in coverage in different parts of the country, providers are the ones who actually create the landscape, meaning a better understanding of what they consider to be competitive pricing and in-demand services means you can adapt your plan along the way to launching new products.

PayrHealth’s direct access to real practices nationwide gives us unparalleled insight into real-time market models that identify the ideal targets for new plan products and market opportunities. With our network development tools at your disposal, healthcare plans can make data-driven decisions about where they should and shouldn’t deploy their time and resources.

2. Failing to Communicate

Countless times health plans have stalled or missed opportunities because teams do not have the willingness or ability to share information across departments and divisions. With a partner like PayrHealth, we provide unified access to information with points of contacts who share a single platform of information to keep everyone on the same page. This means everything from recruiting, contracting, and reporting can all be accessed by the people who need to see it whenever they want.

Another advantage of PayrHealth’s online project management tools is that tasks and documents are made readily available in the case of needing to perform an audit and to ensure your plan meets adequacy requirements in crunch time.

3. Underestimating the Credentialing Process

When launching a new product into a new market, most health plans recognize the need for extensive internal teams or sub-contractors who can handle the tedious but monumental task of credentialing before the plan is viable. However, fewer recognize the long-term commitment an expanded plan requires to maintain adequacy. Providers are constantly shifting and even when it doesn’t affect the overall strategy of a plan, it still requires someone to handle the paperwork to keep that provider in-network.

PayrHealth’s proactive network development strategy includes this additional overhead in the months and years following deployment to help you realize cost burdens on the front end and make the smartest decisions before they become revenue drains.

4. Waiting to Fix Red Flags

Your network development team may be just on the cusp of launching a successful network expansion but someone raises a small issue as you get closer to the deadline. Ignoring red flags, no matter how insignificant they may seem, can land your plan in jeopardy. It’s never too early to admit you might need help from an outsourced team who can quickly onboard your strategy with decades of combined experience. This might save your team from burnout and expand your strategy for years to come.

Network Development Strategy at Scale

PayrHealth is your partner in network development strategy, with our teams of experts and vast data on current market trends in every county across the country and direct access to providers in your strategic interests. Learn more about how our team can help you reach new goals and safeguard your next move by calling us or contacting us online today.

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