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|High Performance Health Networks: Building Coherent Network Design and Implementation Capability|
are becoming more prevalent in healthcare, and with good reason: They
help payors reduce costs and increase the quality of care. However, the
approach for designing and implementing such networks is still evolving.
Many current offerings have fallen short of the expectations of both
patients and regulators, leading to increased scrutiny, new regulations,
and even lawsuits.
Payors can avoid such problems and give themselves a clear competitive advantage by designing high-performing health networks using three criteria: (1) Total cost of care, which considers costs for an entire healthcare
episode from the memberís perspective, rather than the traditional approach of looking at per-visit or per-procedure costs; (2) Quality of care, which entails new metrics to assess whether healthcare is safe, effective, patient-centered, timely, efficient, and equitable; and (3) Consumer preference, which factors in patientsí willingness to
pay for choices in primary care providers, specialists, and specific health systems.
In addition, payors must be able to design and implement networks in a scalable and repeatable way ó and to learn quickly from past experience (including missteps). That requires collaboration among internal functions and management of all external stakeholders: consumers, providers, and regulators. By applying this three-lens approach and improving the way they implement new networks, payors can capitalize on the promise of such arrangements.
Please join us Wednesday, November 4th, 2015 at 2:00 PM Eastern as PwC Strategy&'s Joyjit Saha Choudhury, Jayanth Godla, Jennifer Yaggy, and John Andrewes provide a one hour discussion of narrow network issues. Click here for detailed information and to register or call 209.577.4888.
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