Quest Analytics, the leader in provider network management solutions and services, today introduced Network Performance Services, a new offering that helps optimize provider networks with in-depth performance analytics, competitive network benchmarking and provider claims activity. Through automated tools and available expert consultants, Network Performance Services provide clients with critical performance details enabling resources to design more effective and adequate networks quickly.
From a regulatory perspective, Network Performance Services directly addresses the issue of ghost networks, the phenomenon of insurance directories filled with providers who are not clinically active in their indicated specialty or not accepting patients. Network Performance Services enables clients to move beyond compliance, enabling them to understand how a network performs competitively across a region or specialty and all lines of business, including access/adequacy, affordability/efficiency, and capacity.
“We saw a need in the marketplace to help our clients build networks that deliver high-value healthcare – networks that have strong performing clinicians that are easily accessible and meet adequacy standards,” said Steve Levin, CEO, Quest Analytics. “Network Performance Services leverage the combination of our industry expertise with network, market and claims data viewed through the lens of network adequacy. This unified and expanded network view allows clients to optimize their networks to truly meet members’ expectations while enhancing patient outcomes, lowering costs, increasing speed to market and improving access to quality care.”
Network Performance Services include:
- Provider Claim Activity (PCA) – an automated solution that inspects the clinical activity of providers based on categories of patient volume using all-payer claim information and Quest Analytics’ proprietary national network database.
- Competitive Network Benchmarking – an interactive dashboard that helps an organization understand how its network compares to its peers by geography and line of business across multiple measures: access, demographics and performance.
Network Performance Services in Action: Recently, working in conjunction with a large, national payer client, Quest Analytics successfully designed a compliant and performant network for entry into a new geography. According to Jim Brown, SVP, Network Performance, Quest Analytics, “Quest Analytics’ solution delivered a network that exceeded the incumbent payer networks in adequacy and quality, based upon the client’s framework of analytic measures. This project was completed in less than 60 days, shortening the time to determine a potential network by up to 10 months, and allowed the client to prioritize outreach to a smaller subset of health systems and providers, streamlining the time-consuming process of provider engagement and contracting.”