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The NetMinder Blog

What Gets Measured Gets Managed - Adds and Drops

Posted by Susan Donegan on Thu, Apr 05, 2018

“Adds” are providers that are new to your network – or your competitor’s. Adding new providers to your network means more choice for current clients and less disruption for potential new clients and enrollees. Measuring the number of new providers added to your network, segmenting the new participants by specialty, and sharing reports with clients and prospects regularly can be useful sales tactics.

Adds_Drops

But comparing your adds to those of competitors can be even more valuable. If you’ve added more in total, or more in a particular specialty, the sales team can use this information to demonstrate growing competitive strength. And what if the competitor has added new providers you don’t have? There’s no better way to identify targets for recruitment. 

“Drops” are providers who have left the network. Turnover is an important metric, and is often included as a performance guarantee in RFPs for new business. “After adjustment for plan characteristics, health plans with higher primary care provider turnover rates had significantly lower measures of member satisfaction,” according to a study published in the American Journal of Managed Care.

It is important – and relatively easy – to measure your own turnover rate. This is an indicator executives often use in setting performance targets for provider relations teams. You should be able to drill down geographically, and by specialty. But what if a sales professional could say to a prospective client: “Our turnover rate for primary care physicians is the lowest in the state – 12.5% better than the closest competitor. If you’ve dealt with employees lately who’ve experienced disruption, you know how important that can be!” Specific, accurate comparisons are much more compelling than phrases like “low turnover.” 

Download our whitepaper to better understand the dynamics of provider networks and measuring all of the productivity index components - adds, drops, net change and total change.

Tags: healthcare providers, network disruption, network comparisons, network metrics, network analysis, network strength, network comparison tool

Gauging the Productivity of Your Network Development Activities

Posted by Susan Donegan on Wed, Mar 07, 2018

When you subtract the number of providers who leave the network from the number who've joined for a time period, you get an important metric, Net Change. Net Change measures the overall growth in a network. Potential clients are looking for long-term relationships, and while losing providers isn’t positive, the ability to replace them efficiently is a strength.  

net change.jpg

In the example above, while Network A lost 8% of its providers during the time period versus only 6% for Network B, it was able to more than replace them, with adds of 14%. Network A’s net growth of 6%, compared to the competitor’s growth of just 2%, can be positioned as a clear advantage. From a management perspective, Net Change also serves well as a key performance indicator for provider relations teams.

Another important metric is Total Change, which demonstrates the amount of movement in a network or a market. While Net Change measures network growth, Total Change simply measures movement. It shows the overall change in the makeup of the network over time. Using the previous example, Network A had a total change of 22% (14% adds plus 8% drops) versus Network B’s total change of 14% (8% adds plus 6% drops.)

total change.jpg

Employed by itself, Total Change is not all that revealing. However, when combined with Net Change, it creates a powerful new metric for gauging the productivity of your network development activities compared to internal benchmarks and relative to your competition, which we call the Network Productivity Index.   

Download our whitepaper to better understand the dynamics of provider networks and measuring all of the productivity index components - adds, drops, net change and total change.

Tags: compare networks, network comparison tool, network growth, health insurance, network productivity, healthcare providers

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

NetMinder Shows the Maximum and Compares Your Network to the Competition

Posted by Susan Donegan on Fri, Dec 01, 2017

In order to present a more complete picture of network strength relative to a population, we propose including another metric – choice of providers – to the analysis. When you add the average number of providers employees can choose from to the percentage of employees with access to a minimum number of providers, you can better assess the relative strength and attractiveness of one network versus another.  NetMinder shows the maximum.jpg

Using an employee census to run a network summary report gives you the opportunity to focus your analysis on areas important to the client - do large concentrations of employees have adequate choice?Network Summary Report sample.jpg

The resulting report output shows that while My Network doesn’t have the most providers within 5 miles of the employees, (327 versus 337 for Competitor C), it does have the most choice (14 providers on average vs. 11 for Competitor B) in my census locations and it meets the accessibility criteria - 100% of employees having access to at least 5 providers. Therefore I can say to the prospect or the broker that My Network is the strongest option for this group of employees – all employees have the required network coverage and the most choices of providers. 

Watch and learn how to get the most out of NetMinder using your client's employee census.

Tags: compare networks, network comparisons, network comparison tool, health care provider, ZIP census

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

4 Ways to Measure Network Strength

Posted by Susan Donegan on Thu, Sep 14, 2017

The health insurance industry has developed a spectrum of network analysis tools to demonstrate a network’s breadth and depth, and to differentiate between networks.There are 4 common methods of network analysis widely used to evaluate health-related insurance products today. We visualize this spectrum as a pyramid to show how frequently the analysis is used and how specific the information is to each company. As you ascend the pyramid the frequency of availability decreases but the knowledge gained becomes more specific and as a result is more valuable to the overall assessment of the networks under consideration.4 ways to measure network strength.jpg

For example, at the bottom of the pyramid, measuring network size is fairly easy and is used in almost every analysis; it’s not very specific to a particular client or prospect. At the top of the pyramid, re-pricing the claims of the incumbent carrier is more difficult to do because it requires more data and cooperation from the prospect and the incumbent, therefore it’s done less frequently. However, when done, it’s very specific to the prospect’s situation. 

Download our whitepaper, The Network Analysis Pyramid for an overview of the most widely used methods to analyze provider networks.

Tags: data analysis, health insurance, compare networks, network comparison tool, network data, repricing analysis, provider networks

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

Five Best Practices to Use Network Data to Grow Your Business

Posted by Darrin Hall on Thu, Jun 26, 2014

There are many factors employers consider when selecting an insurance carrier: price, benefits, service reputation and, to an increasing level of scrutiny, provider network. Positioning your provider network as the best fit for a client or prospect can make all the difference in winning the business.

Provider networks have to satisfy customers and members on multiple levels: 

  • Wide range of choices: multiple general and specialty providers are included in the network
  • 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
  • Cost-effective: in-network providers offer meaningful discounts that reduce out-of-pocket expenses and claim costs

Because the provider network is hard to measure and so important to winning and retaining business, the industry has developed four types of network analysis:network analysis pyramid

  • Network Counting – measure the quantity of providers in each network
  • Accessibility Analysis – correlate network provider locations to employee home and work locations
  • 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

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

Insurance companies and network leasing partners are both the source of the data in these reports and the consumers of the analyses during their sales processes. This dual role provides incentive to invest the resources needed to prepare and maintain network data so that they are in the best position to win new business.

So, what can you do to show your network in the strongest position?

Here are five best practices for managing your network data that will give you the best results in your network comparisons.

  1. Review your directory data regularly. Be sure that provider names, addresses, and phone numbers are up to date. Transparency in your reporting will be to your advantage in the long run.
  2. Check for duplicate records that can be consolidated, especially if you are stacking networks, since it can be hard to identify providers from the vendor network that are already in the carrier network.
  3. Adopt data standardization practices, particularly for numeric fields. For example, make sure leading zeroes on ZIP codes have not been dropped and replaced by the first digit of the ZIP+4. This is common in ZIP codes in New England, New Jersey, and US Caribbean territories.
  4. Consider including competitor network data in your analyses so that you understand your competitive position, predict results, and prepare for the future.
  5. For Disruption Reporting and Repricing, make sure that provider name data is properly parsed and address data is standardized. Use the same processes for claim and provider data files to give best chance of identifying valid matches.

Earning new business and retaining current customers are the lifeblood of every company. Improving your position by cleaning and maintaining your network data can make it easier to do both.

What process do you use today to manage your network data?

 

Tags: health insurance, network providers, network comparison tool, network management, provider networks, network data, disruption reporting, insurance companies, network leasing companies

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

 

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