Health plans are only as good as the providers they’ve contracted with. A strong network of specialists creates incentives for patients and gives your plan a competitive advantage, creating a win-win scenario for the most robust health plan networks. To expand sustainably and profitably, keep these tips in mind.
Consider Depth, Breadth, and Specialty of Providers
The one thing most plans seek to do when considering network development is to expand into new counties or new states. However, location is only one of the factors you need to consider to expand in a way that attracts new patients and allows you to access new lives.
Simply adding more providers to your plan without knowing which hospitals, specialists, and private practices are preferred in the area may not be the best strategy. Instead, access robust data of practices and providers through PayrHealth to know exactly which providers are growing and attracting patients to help your plan make smart decisions about where and which caregivers will be sustainable for growth beyond adequacy.
Geography is important, but so is quality of care. Our strong relationships with providers allows PayrHealth’s network development team to know who provides outstanding care in the area you’d like to expand your plan. We know the personal testimonies of patients who may live and work across county or even state lines and can help you pinpoint providers that match perfectly with your goals.
Maintain Profitability With Tiered Access
Contracting with new provider networks can be profitable and affordable for patients with tiered plan options. Designating preferred providers incentivizes them to keep their quality high while offering care at low rates for members, who can still access specialists throughout the network with higher out-of-pocket costs if they want. This also plays into your plan’s offerings for large-group employees in certain areas, allowing them to get care no matter where they live or work if not in the same county.
Collaborate With Providers For Innovation
By partnering with PayrHealth and our extensive network of physicians nationwide, we provide communication channels that can help your plan innovate and expand services or create new processes that work out for everyone involved. For example:
- Distributing information to the entire plan about new programs, procedures, or treatment options
- Establish referral pathways for specialty care for preferred providers that utilize consistent codes that can lower costs and drive growth to practices
- Reduce overlaps in care by examining anonymized patient data and creating preventative care protocols that reduce costs for members and your plan.
Too often the practice-plan line of communication closes after your plan has been allowed to expand with their services. Keep it open with our practice specialists and network development team to continually find new opportunities to cut costs, expand care abilities, and access new lives.
Network Development With PayrHealth
We seek to be the bridge between providers and payors with experience in all 50 states having negotiated thousands of contracts. Let us introduce you to our network of providers and help you expand your plan with data-driven decisions. Call or contact us online today to get started.
