By Keith Belton | February 15, 2019
The rush by clinically-integrated and narrow networks to win market share is on.
A consensus view of US healthcare is that the proportion of spend through risk-based contracting will continue to rise.
In 2016, nearly 30% of all Medicare and Medicaid spend was for care under a value-based or risk-sharing agreement.
Your managed/value-based care revenue goals may be worth tens of millions or hundreds of millions of dollars’ worth of revenue in 2019. Regardless of your network’s size, your providers are your meal tickets, coordinating and delivering care. And everyone in the network related to registering, scheduling, referring, and billing for patients needs to know who’s in and not in your networks…to keep patients in-network.
More on what you need to know about these providers below:
Net, winning market share depends on how effectively you manage your provider network.
If that’s the case, then…management-by-Excel is no way to manage your clinical network.
Your managed care/network management team’s principal tool to meet this challenge – a spreadsheet, a tool from the past – needs to become a thing of the past.
If you’re looking to double your provider reach and participation in 2019, you’ll need a more sophisticated platform to track provider NPI, TIN, specialty, location, networks and health plans they honor…and more. Imagine if your network grows to 3,000, 5,000 or 10,000 providers? And you need to keep track of 100 data points per provider? You’re looking a maintaining a spreadsheet with a million cells.