Health insurance companies struggle to quickly, efficiently, and cost-effectively create their care networks--the very products they depend on to stay in business. Almost all of the challenges are rooted in an outdated, very fragmented way of managing networks. Data is segmented into different departments. Multiple systems are used for different network management functions. And networks are siloed off into different systems. Not surprisingly, such a flawed system is the cause of equally fractured relationships with providers. It also hinders rapid expansion into new markets.
This guide shines a light on a more productive (and greatly simplified) way to create and manage the kind of care networks both providers and consumers want to be in. Readers will walk away with a confident understanding of how to replace their fragmented, disorganized network management with a centralized and enterprise-wide platform recognizable through four essential characteristics. Such a platform:
- Houses a seamless collection of core business functions that work interdependently together
- Makes all networks and network-related data visible
- Is provider-inclusive
- And integrates network management with other data and systems inside and outside the payer enterprise
The result is nothing less than an overdue reinvention of network management and provider relations for today’s consumer-driven healthcare.
Synopsis: “The Agile Provider Network”
Gartner, Cool Vendors in Health-Value Management for U.S. Healthcare Payers 2017, Bryan Cole, Jeff Cribbs, Brad Holmes,11 April 2017.
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