network data is useful. netminder knowledge is powerful.

The NetMinder Blog

Estimating Network Disruption

Posted by Laura McMullen on Fri, Mar 18, 2016

Network disruption is an important consideration to an employer group planning to change insurance plans. People are attached to their doctors. A 2014 Becker’s Hospital Review/Survey Monkey survey asked people “how much they would have to save on premiums to choose a plan that forces them to change their primary care physician. The median response was a savings of $100 a month, but some people would ask for a lot more, including 28% who would want to save at least $200 a month.” 

That’s why disruption reporting is an integral part of many negotiations. Part of the plan selection process for large groups or self-insured groups is to run a disruption report using past claims experience to estimate savings in the proposed plan. But what do you do when you don’t have the claims data for a formal disruption report?

Using the Network Overlap report to evaluate disruption is a great option for smaller groups where the decision timeline is short and claims data unavailable.

disruption_graph.pngWhat does the Network Overlap report show?

This report compares two networks side-by-side, providing total, overlapping, and non-overlapping counts for each of the two networks by geographic area and specialty. ZIP codes with high overlap percentages will have less disruption than ZIPs with high unique percentages.

How does it work?

Upload your file using the UPLOAD ZIP CENSUS option in the geographic scope selection box and make the rest of your choices as usual to get started.  Running this report with custom census geographies simplifies your analysis:

  • Understand disruption for all employees in the same report. All of the ZIP codes in the file will be included in your report – even if they are not all in the same state.
  • Clarify network access in and around home and work locations. The report will return 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. Be sure to subtotal your report by ZIP5 to see the results for each ZIP code separately.

There aren’t too many opportunities to sell health insurance to a company that isn’t currently offering it to their employees. Demonstrating minimal network disruption can be the difference between a successful takeaway and a lost bid.

How do you estimate network disruption for current and prospective customers?

Tags: health insurance, disruption reporting, network change, ZIP codes and cities, network overlap, network disruption

4 Network Metrics to Help Make Your Network Stand out from the Crowd

Posted by Laura McMullen on Wed, Aug 26, 2015

In a previous post, we talked about the four types of network analysis the employee benefits industry developed to measure and compare provider networks. Each type of analysis is valuable at different points in the selling process:

  • Early stages to convince groups and brokers to consider a network
    • Network counting: measure the quantity of providers in each network
    • Accessibility analysis: correlate network provider locations to employee home and work location
  • Later stages to demonstrate savings and convenience for members
    • Disruption reporting: match historical provider utilization and claims experience for a group to the providers in a different network
    • 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
Apples_ResizedBut not every selling situation calls for a report. Sometimes all you need are a few metrics to catch someone’s attention so that you can have a larger discussion about why your plan is a good option for a group. Here’s a look at four network metrics that can help you make your network stand out:
  1. Counts. Access points, unique providers, or unique locations? Choosing the right counting method can make all the difference in how your network is perceived. If you have fewer access points and fewer locations/provider you might find that a unique provider count presents a better picture of your network than access points.
  2. Locations/provider. Use the NetMinder Snapshot to find this metric or compare access points to unique locations to see how your network looks versus your competitors’ networks. A high locations/provider ratio can indicate directory inflation.
  3. Total change. The sum of adds and drops in a network during a specified time period. Use this metric to showcase a geographic area – deliberately adding and removing providers to improve the network.
  4. Net change. The difference between adds and drops in a network during a specific time period. Use this metric to show growth or contraction over time.
    (Total change and net change are both available in the NetMinder Network Change report.)

In general, the process of comparing provider networks is the same whether you are comparing dental, vision, or medical HMO networks. However, each line of business has a few specific metrics to address unique situations. Here are a few that we use regularly:

  • PCPs/total providers. The percentage of a medical network that is primary care providers (usually internal medicine, general practice, family practice, OB/GYN, and pediatrics) is particularly important when evaluating a medical network. A lower percentage can result in longer wait times for members to get appointments. It also could indicate that different types of providers are identified as PCPs which could also cause disruption to members when changing plans.
  • ECPs/total providers. The percentage of a vision network that is eye care providers (optometrists and ophthalmologists) is a significant distinction. Consumers gravitate to ECPs for exams and retail chains for glasses and contact lenses so having a selection of both types of providers can increase member satisfaction.
  • Practicing providers and locations/all locations. The percentage of a dental PPO network that is practicing can make all the difference because directory inflation is common. NetMinder validates locations using claims data which helps focus recruiting efforts and clarify the network landscape.

When you tell your network story, which metrics do you use to support it?

Tags: compare networks, network metrics, health insurance, network comparison tool, disruption reporting, network change, provider networks, employee benefits

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

Measuring Productivity and Activity in Provider Network Recruiting

Posted by Laura McMullen on Thu, May 29, 2014

As you can imagine, we’re always thinking about building, maintaining, and selling provider networks. The most frequently asked question we get is how can I show my network in the best possible light; even if it isn’t the largest in a particular geographic area? One way is to look at recent growth (or contraction) trends.

There are several metrics that illustrate growth or contraction:

  • Adds: number of providers that were new to a network since the last update
  • Drops: number of providers that left a network since the last update
  • Net Change: difference between Adds and Drops
  • Total Change: total of Adds and Drops

Each metric has value, depending on the analysis you are doing. For example, simple counts of Adds and Drops measure the activity in a network while Net Change shows growth over time.

The Network Change reports in NetMinder analyze a network at two points in time. They bring all four metrics into one convenient report for selected specialties and geographic areas. Like other NetMinder reports, the summary report shows counts and the detail report gives lists of providers with their contact information. Watch a Quick Take video to see how the reports work.

Measuring Productivity Instead of Activity

network changeWe’ve all heard the expression “change for change’s sake” and know that’s not a good thing. In network management, the primary purpose of change is growth, so any change that doesn’t result in growth is potentially unproductive. That’s why we added the Network Productivity Index to the Network Change reports. This index compares net change to total change to measure how much activity is productive. The index values range between zero and 1; where 1 means that 100% of activities during the comparison period resulted in growth. For example, even though two networks in the same county are roughly the same size, Network A had fewer drops and less change resulting in an NPI of .42, significantly higher than Network B’s .04.

Measuring productivity is important because networks with high turnover may have higher rates. It costs more to recruit a new provider than to keep an existing one. Higher costs ultimately lead to higher rates so the more productive a network’s recruiters are, the more competitive the rates can be. And the ability to quickly replace providers who leave a network satisfies customers and members leading to high retention rates on the sales side, as well.

For more ideas about using network change metrics, download our whitepaper How Productive is Your Provider Network.

Which metric do you think is the most important metric in managing productivity for the networks you manage and sell?

Tags: network metrics, network rank, network providers, network comparison tool, network change, network management, network productivity, provider networks

 

CONNECT WITH US

linkedin-blue-1

 

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

Login               › NetMinder Blog               › Join our LinkedIn Group