network data is useful. netminder knowledge is powerful.

The NetMinder Blog

Minimize Disruption by Maximizing Overlap

Posted by Susan Donegan on Thu, Aug 10, 2017

In order to minimize disruption for potential new clients, a dental plan needs to maximize its overlap with competitors' networks. In other words, they need to have as many of the same dentists as possible. What might be a manageable task when aiming to match up with a single competitor, this gets quite challenging for a plan with 8-10 significant competitors.network overlap.jpg

In the chart above, the blue circle represents Network A, a middle-of-the-pack network among the Top 15 dental PPO plans, while the gold circle represents the average of all of the Top 15 dental PPO plans. Network A, though quite large, only overlaps with its peers at a rate of 57%. This means that while 6 out of 10 access points in Network A's network are likely also to be in any given competitor's network, 4 out of 10 are not, and will potentially cause disruption for a prospective client. The challenge for Network A, as it is for all dental plans looking to grow, is to maximize their overlap with key competitors so that potential clients will experience minimal disruption when switching to their plan.  

Download our whitepaper, Recruit Smarter, Not Harder to learn how NetMinder data can help you target and recruit dentists more successfully and efficiently. 

Tags: market comparison, health insurance, disruption reporting, network overlap, network disruption

Including employee census data in your network analyses

Posted by Laura McMullen on Thu, Jan 15, 2015

Employee censuses are the heart of the group insurance business. Sales and underwriting teams use them during the sales process, enrollment portal credentials are established using them, and billing and eligibility files are subsets of these lists. Another common use is network accessibility analyses to determine how many providers are within a standard distance.

To take accessibility analyses a little farther, consider including NetMinder reports in the underwriting process to see where you have network advantages and disadvantages for a specific employee population. When you are a finalist for a group, there’s usually only one or two other competitors to evaluate. For some cases though, it’s worth it to compare to a larger group of competitors early in the process to give your team the best possible chance of winning.

To make this analysis easier, we recently added the capability to run NetMinder reports using your client’s employee census to select the geographic area you want to analyze.

Upload your file using the UPLOAD CUSTOM CENSUS option in the geographic scope selection box and make the rest of your choices as usual to get started.

custom_zip_1

Custom_Zip_2

 

 

 

 

 

 

Using custom census geographies has these benefits:

  • Your network comparison will include all of your client’s key areas and match up easily with other analyses.
  • All of the ZIP codes in the file will be included in your report – even if they are not all in the same state.
  • You can use custom census geographies with any NetMinder report – summary or detail. The report will return counts or details for the networks and specialties you select in the counties that contain the ZIP codes in the census file. For example, if 33433 and 33313 are in your census, the report will show Florida as the state and results in Palm Beach and Broward counties.

How do you match employee censuses with competitive network data?

Tags: market comparison, data analysis, insurance companies, network comparisons, ZIP codes and cities, Custom Geographies, NetMinder new features

Five Best Practices to Find the Right Provider Network for Your Customers

Posted by Laura McMullen on Thu, Jul 24, 2014

In a recent blog post entitled, Five Best Practices to Use Network Data and To Grow Your Business, we wrote about the ways carriers and network leasing companies can improve their position in network comparisons by better cleaning their data. Another point of view is from the brokers and consultants who use network analyses to help their customers choose the right benefit plans.

health insurance plansShopping for employee benefits is complicated and time consuming. Employers and other plan sponsors typically rely on a broker or consultant to help them through it. Brokers and consultants know that network issues can turn a satisfied customer into one that goes out to bid in the blink of an eye. Even if everything else is right: price, benefits, service, and timely and accurate claims payments can’t outweigh a network that doesn’t fit the employee population.

As we pointed out in our other post, the best networks:

  • Offer a wide range of choices: multiple general and specialty providers are included in the network
  • Are convenient to use: providers are located near home or work
  • Include popular providers and facilities: providers are the ones that members and their families want to use
  • Save employers and employees money: in-network providers offer meaningful discounts that reduce out-of-pocket expenses and claim costs

Depending on the number of employees your customers have, different types of network analyses are probably available from your carrier partners. Generally, we see four types of network analysis:

  • Network Counting – measure the quantity of providers in each network (available for groups of all sizes)
  • Accessibility Analysis – correlate network provider locations to employee home and work locations (available for groups of all sizes)
  • Disruption Reporting – match historical provider utilization and claims experience for a group to the providers in a different network (available for groups with at least 200 employees)
  • Repricing – compare cost of claims for all providers (in- and out-of-network) if a different network were in place to the cost experienced in the current network (available for very large or self-funded groups)

Download our whitepaper, The Network Analysis Pyramid, to learn more about each method.

As the primary users of network analyses, brokers and consultants are in a unique position to influence the requirements of each type of analysis. Keep these five best practices in mind as you work with carriers on your customers’ behalf:

  1. Insist on clean, accurate data so you get clean, accurate reports.
  2. Clearly identify required fields and formats in all file requests.
  3. Obtain claim data from the incumbent carrier whenever possible.
  4. Choose a consistent counting method for all reports to ensure that you are comparing apples to apples.
  5. Evaluate key specialties separately from the overall network based on your client’s needs.

With all of the changes from the Affordable Care Act, employers and other plan sponsors are relying on brokers and consultants more than ever.

How do you evaluate networks today?


 

Tags: compare networks, data management, market comparison, network metrics, dental network, network providers, health insurance, Affordable Care Act, network comparison tool, disruption reporting, data analysis, network change, Healthcare, healthcare reform, health reform, ACA, healthcare exchanges, provider networks, health insurers

Narrow Networks Add Complexity to the Health Insurance Business

Posted by Laura McMullen on Thu, Apr 24, 2014

narrow networksThere’s been a lot of buzz in the media lately about narrow networks in health insurance plans on the federal and state health insurance exchanges. This has prompted a larger discussion about network adequacy and the trade-offs between cost control and choice. Carriers Defend Use of Narrow Networks as Fair, Market-Driven Options for Consumers, an article from Health Plan Week reprinted in AIS Health Reform Week on April 4, 2014, sums the situation up well, discussing network adequacy, consumerism, and transparency.

Here are some questions to think about when you are comparing provider networks, whether you are managing a network, selling insurance plans to employers, or purchasing a plan for your company or family.

1. Are the right types of providers in the network? When provider networks get narrower, the definition of network adequacy shifts from the size of the network to the types of providers that participate. Employers and other group benefit sponsors are asking questions like: Are there enough PCPs or optometrists? What about cardiologists or oral surgeons? How many radiologists or ER doctors are near my members? (Download our whitepaper All Provider Networks Are Not Created Equal for more.)

2. Is the carrier financially and administratively reliable? Narrow networks reduced one of the barriers to entering the health insurance market, namely the need to have a large provider network. Many new entrants to the market raise questions about financial solvency and claim payment speed. 

    • In the dental insurance industry, we’ve seen established brands like Prudential come back to the market with a leased network and outsourced back office only to exit after a few years. (See our blog post Prudential Exits Dental Benefits Market; Others to Follow? for more.) 
    • In the health insurance industry, more than 50% of hospitals and health systems responding to a June 2013 Advisory Board Co. survey said that they planned to launch a health insurance plan by 2018 or they already had one. (See our blog post More Health Systems Becoming Payers for more.)

3. Are the right providers in the network? From the consumer perspective, all networks are narrow – they only include the providers they use! Many people are accustomed to the large PPO networks that have been popular in employer-sponsored plans over the last several years, so they may be surprised by narrow networks that don’t include popular providers and academic medical centers. Communicating early and often, like B2C companies do, could make a big difference here. For more about how consumers look for health care information online, see our blog post Consumers Seek Real Data Online for Health Decisions.

Key questions for the Department of Health and Human Services in the coming weeks and months will be which types of providers are essential and how large is an adequate network. As they work on the answers for plans on the exchanges, carriers will be watching closely to see what the impacts are for plans off the exchanges.

How will you assess your network and your competitors’ networks?

Tags: compare networks, market comparison, network providers, health insurance, narrow networks, Affordable Care Act, healthcare reform, health reform, healthcare exchanges

NetMinder Snapshots and Reports: Something for Everyone

Posted by Laura McMullen on Thu, Feb 27, 2014

When I’m talking to new NetMinder users, they ask when to use the different reports. This blog post compares NetMinder Snapshots to standard NetMinder reports.

We recently launched Snapshots to give users a quick way to compare all of the networks in their subscriptions at the same time and to give insight into where one network ranks in a market against all networks in our database, even the ones that aren’t in your subscription.

To run a Snapshot, users make just three selections:
  • a geographic area
  • counting method
  • whether to compare to the networks in their subscription or to the market at-large

Snapshots, which run with just a few clicks on a single screen, work well as a complement to standard NetMinder reports, which give users more flexibility to include multiple geographic areas, choose which specialties and/or networks to include or exclude, and choose between summary counts and detailed lists.

In general, use Snapshots for high‐level overviews of provider counts and metrics in a particular area and use Standard Reports for more detailed information. Here are some examples:

 

Standard Reports

Snapshots

I want to compare counts for all networks in my subscription to each other for the whole country or a single state, MSA, or county for all specialties.

   Yes

I want to see a detailed list of provider contact information.

 Yes  

I want to compare my network to all the other networks in a market.

   Yes

I want to see the counts of adds and drops for a network since the 
previous update.

 Yes  

I want to see the counts for three networks in my subscription in five
ZIP codes.

 Yes  

I want to see the overall increase or decrease in a network since the previous update.

   Yes

Right now, Snapshots are available for dental PPO subscriptions; we plan to launch for the other products soon. Have you tried the NetMinder Snapshots yet? What do you think?

Tags: market comparison, network metrics, network rank, dental PPO networks, provider counts

 

CONNECT WITH US

 

NetMinder delivers industry leading network comparison tools that make your sales force more effective and your recruiters more efficient. Network data is useful. NetMinder knowledge is powerful. Learn More About What We Do

 

RESOURCES