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The NetMinder Blog

Do We Count Access Points or Unique Providers?

Posted by Laura McMullen on Thu, Feb 08, 2018

This question has been around since the first time someone decided to compare two provider networks. In fact, NetMinder wouldn’t be here without it! One of our founding principles is a commitment to comparing apples to apples. This thread runs through all our processes starting with the way we collect data and ending with selecting report criteria. We’re focused on this idea because we know that how you count network providers can make a big difference in calculating network strength. Read our whitepaper about counting providers.

Choosing The Best Counting Method For Your Analysis

Each counting method has strengths and weaknesses. Access points is the broadest count with the highest numbers. It’s great for showing consumers where they’ll be able to access care. Unique providers (sometimes called “belly buttons”) is often the cleanest count and preferred by benefits decision-makers. It’s not so good for consumers since it doesn’t show all locations. Unique locations (sometimes called “doorbells”) is the narrowest count with the smallest numbers for obvious reasons.

One Report To Show Them All

Dental_Dashboard.jpegMaking sense of these options is why we added a new Dental Dashboard to our suite of snapshot reports. It shows all three counting methods plus validated counts and percentages for a single geographic area in the same report. The six bar charts bring access points, unique providers, and unique locations together for up to five networks. Watch this video to learn more.

Each counting method is important at different points in the sales and renewal process and the Dental Dashboard makes it easier to look at them all. For example, access points are important to consumers when they are making appointments while HR teams rely on unique providers to compare networks. This report helps you prepare for questions about both scenarios and encourages a broader view of the reliability, convenience, and strength of your network.

How are you counting and comparing the providers in your network?

Tags: access points, unique providers, counting method, compare networks, provider network, network strength, network providers, unique locations

Synergies Helping the Dental and Vision Insurance Markets Work Together

Posted by Susan Donegan on Fri, Jan 26, 2018

In dental and vision insurance, the network is where the consumer experience happens. That’s why it’s important to know the network landscape and leverage all points of differentiation and separation from the competition.

First, a few definitions. These observations are based on a review of NetMinder data for the top 15 national dental PPO networks and the top 10 vision networks as of March 2015. A network is defined as a payer/plan combination, i.e. Delta Dental PPO or EyeMed Access. Counting methods are:  

  • Access Points: each provider at each location in a provider directory.  
  • Unique Providers: each provider one time regardless of the number of locations s/he is listed at in a provider directory.
  • Locations: each location one time regardless of the number of providers who are listed there in a provider directory.

AvgNetworkSize.jpgRelatively speaking, dental networks are much larger than vision networks. The supply of dentists is larger than the supply of optometrists and ophthalmologists. There are 65 dental schools vs. 23 optometry schools23 and nine dental specialties vs. two optometric specialties.

There is also greater demand for dental services:

demand_dental_vision.jpg

Download our whitepaper to learn more about these favorable trends as well as the synergies that help the dental and vision insurance markets work together. 


23 https://en.wikipedia.org/wiki/List_of_dental_schools_in_the_United_States:
24https://www.quora.com/How-long-does-a-routine-dental-checkup-normally-take-in-the-U-S-if-the-patient-is-perfectlyhealthy-and-schedules-one-every-six-months
25http://www.webmd.com/eye-health/what-to-expect-checkup-eye-exam-adults#1
26 http://health.costhelper.com/teeth-cleaning.html
27 http://eyeexamcosts.com/understanding-eye-doctor-costs/

Tags: dental insurance, Vision insurance, vision networks, dental network, access points, unique providers, provider locations, practicing locations, NetMinder, network analysis, network comparison tool

If You Think All Provider Networks Are Basically The Same, Think Again

Posted by Susan Donegan on Thu, Oct 19, 2017

After years of insurance companies and PPOs building and maintaining provider networks, the prevailing wisdom is that “all provider networks are basically the same.” A closer look at the composition of provider networks reveals something very different, however.

A comparison of two well-known, established provider networks in Florida shows that, while they both have almost the same number of access points (provider locations), the overlap between the two networks is only 47%. More than half of the access points in each network are unique to that network.comparison similarly sized networks.jpg

In order to better understand the differences between these two networks, we need to drill down to the specialty level. As you can see in the chart below, both networks have basically the same composition of Primary Care, Medical Specialists, and Surgeons. However, they vary significantly in other specialties such as Dental and Vision, Nursing, Therapists, and Behavioral Health.

specialties.jpg

It’s important to know which specialties are included in a provider network in order to be able to make an accurate, fair comparison.

Download our whitepaper, All Provider Networks Are Not Created Equal to learn how to use network data to demonstrate your competitive advantages for a specific client's needs.

Tags: provider networks, network comparisons, provider network, access points, provider locations, network comparison tool, provider directories

The Provider Directory is a Valuable Marketing Tool

Posted by Susan Donegan on Fri, Aug 25, 2017

A dental provider directory can be a valuable marketing tool for a dental plan. A large provider directory means more access to care for the members of the plan. And the conventional wisdom is the larger the directory the better.

dental-networks-over-stated.pngA provider directory grows in two ways:

  • by adding providers (dentists), and
  • by adding provider locations (places the dentist practices at).

The combination of providers (dentists) and all the locations they practice at is commonly referred to as access points, or provider/location combinations where a member can “access” care.  

The Industry Is Concerned That Access Is Overstated

One of the concerns in the industry regarding the access points counting method is that providers are being listed at more locations than they actually do or can practice at. This phenomenon is due to a few factors. First, just the like rest of us, dentists retire, sell their practices, or die. Second, associate dentists (employees) tend to move from practice to practice. In both of these situations, it is difficult for dental plans to stay on top of this information, and there may be a significant lag when updating provider directories.

Finally, and most importantly, large dental groups with multiple offices ofen require that dental carriers list all of their dentists at all of their locations, even though they may only regularly practice at 2 or 3 locations. This is so that they can easily move dentists around without disrupting claims payment from the carriers. There are more than 1,300 dental groups nationwide with 5 or more locations, with the average group having 13.7 locations, resulting in overstated access in provider directories. (NetMinder, March 2011) 

Download our whitepaper,  Are Dental Provider Directories Overstated?  to learn more about using "practicing" locations to get a better picture of network access.

Tags: provider directories, dentists, access points, network access, practicing locations, dental plans

Which Counting Method Should You Choose?

Posted by Susan Donegan on Thu, Jun 08, 2017

apples to apples.jpgClients and brokers expect to see an “apples-to-apples” comparison of price and benefit design. NetMinder lets you do the same for networks. Choosing your counting method ensures that you always know what you are counting.

Comparing access points is important at the beginning of the evaluation process because it gives you the most granular view of each network. The networks look largest through this lens because each provider at each location counts as one access point. This view includes all locations that each provider could practice at, even if he or she doesn’t see patients there regularly. To avoid this problem, use the unique provider counting method.

The count of unique providers is the clearest count of contracts that each network has. Looking at the network this way can make them seem smaller since many providers practice at more than one location. This method of comparison complements the access point analysis as you continue to position your network.

Matching counts of unique locations is the methodology that carriers use in the accessibility reports they run against clients’ employee census. These reports generally show you which zip codes meet the minimum access standards. Evaluating networks this way returns the smallest counts and is usually one of the last steps in the decision-making process.

Download our whitepaper, How You Count Matters As Much as What You Count  for more detail on how to make accurate, effective provider network comparisons.

Tags: counting method, access points, unique providers, health insurance, health care providers

 

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