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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

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

Accurate Provider Directories Make Network Comparisons Easier and More Compelling

Posted by Laura McMullen on Mon, Oct 17, 2016

Provider directory accuracy is an important topic for consumers, providers, and payors. It’s obviously very important to us, too – in fact, nearly half of our employees are focused on data accuracy and integrity every day.healthcare_directory.jpg

That’s why we’re following the progress of federal and state regulatory initiatives around ensuring accuracy very closely. I came across an article from Medicare Advantage News (login required) recently that summarizes official remarks at the Medicare Advantage and Prescription Drug Plan fall conference discussing the pilot program conducted by CMS’ Medicare Drug & Health Plan Contract Administration Group to assess directory accuracy. In this initial program, they found:

  • Nearly half (46%) of locations had errors meaning that at least one data element in the directory for that location was inaccurate. Most of the organizations reviewed were 20%-60% inaccurate.
  • Two-thirds of the deficiencies involved listing providers at locations where they don’t practice.
  • Ten percent of the deficiencies were incorrect phone numbers.
  • Twelve percent of the deficiencies were incorrect addresses, including incorrect suite numbers.

The study focused on large organizations with multiple locations and many providers, ultimately contacting nearly 6,000 primary care physicians, oncologists, ophthalmologists, and cardiologists at 11,646 locations. Based on our experience with directory data, inaccurate data is more likely with large practices that include many providers and locations. Take a look at our whitepaper about overstated access in dental directories for more on this subject.

Inaccurate provider directories frustrate members and providers and they also make it hard to compare your network to your competitors’ networks. Here are five best practices for managing your network data that will help you find inaccuracies in your network and make your network stand out:

  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 as it increases member and provider satisfaction by making your directory more reliable.
  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. This will also help streamline your directory validation programs.
  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. Cleaner data is easier to manage and compare.
  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.

How are you validating the provider demographic information in your online directory?

Tags: network comparisons, provider directories, data analysis, network data, directory accuracy

10 Key Data Points for Conclusive Network Comparisons

Posted by Laura McMullen on Fri, Jul 15, 2016

Critical Capabilities for Better Network Comparisons

ten_key_data_points.jpgProduct, sales and network teams’ needs are deeply intertwined — and success for each team relies on the ability to find the edge against competitor provider networks. When high-level comparisons suggest networks are the same or no advantage appears, that’s your cue to dig deeper.

Based on our work with more than 50 healthcare companies (and their aggregate 4,500 users), we offer 10 metrics that are critical for making more effective comparisons — which ultimately means designing better networks and selling more effectively against your competition.

The “Must Have” Capabilities for the Three Major Counting Methods

When you compare networks, how you count really matters. Different comparisons return different results, and are useful for different purposes. Selecting the right comparison method is key to your network development strategy, and to helping clients make better decisions.

In most cases, you’re counting by access points, unique providers and unique locations. Take a look at our whitepaper, How You Count Matters as Much as What You Count, for tips about choosing the right counting method for your analysis.  

10 Key Data Points You Must Have

Let’s add an overlay to the capabilities that drive the three effective counting methods — 10 metrics that must be pinpointed for your network development and sales efforts to make meaningful comparisons:

  1. Which network has more unique providers?
  2. Which network has more access points?
  3. How truly similar are the networks you compared? (In other words, how many providers are in both networks?)
  4. How many of each specialty category does each network have?
  5. Based on member demographics, which specialties are most important in this situation? Which network has more?
  6. How many providers in each network are within an X-mile radius of the locations where your group lives and works? Your radius might be smaller for urban ZIP codes and larger for rural ZIPs.
  7. How many locations/provider are in each network? When this ratio is high, directory inflation could be present.
  8. How many providers/location are in each network? When this ratio is high, large practice negotiations could disrupt the network.
  9. Has the network grown or shrunk overall during the last year or six months?
  10. What type of recruiting activity has there been recently? Adding new providers or replacing providers?

If you cannot decisively answer the 10 questions above, you may be missing key opportunities in network development or sales. You would not be alone in this regard: many competitive network data providers exist, but most provide cosmetic ease of use at the cost of more flexible and powerful reporting options.

If you find your teams hamstrung in their quest to make more effective comparisons — and ultimately drive more profitable activity at every level of your organization — click here and get in touch with us. We’ll talk about a better way to find and capitalize on critical points of difference.

Tags: network comparisons, provider networks, compare networks, data analysis, network development

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.

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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

Flexible Geographic Groupings in NetMinder

Posted by Laura McMullen on Mon, Dec 22, 2014

Competitive network data is valuable to a variety of people in the employee benefits industry. The most common uses we see are sales people comparing networks for a current or prospective customer or broker, or network managers building recruiting lists. Some marketing departments use competitive network data in collateral and strategic planners use it to help chart the way forward.

This wide variety of users has an equally wide variety of preferences. Like many other systems that include geographic analysis, NetMinder uses standard groupings – from the whole country down to a single five-digit ZIP code – to make it easy to match up with other datasets such as procedure-level cost data, membership counts and employee populations. But sometimes you need to slice the data a little bit differently. Maybe you have sales regions that include several states or underwriting zones made up of three-digit ZIP codes. That’s why we added custom geographies.

Here’s what custom regions (groups of states) look like in NetMinder. In this example, the client included 6 states in their Mid-Atlantic region:

custom_geos

You can also set up groups of three-digit ZIPs as markets and groups of counties as territories. There’s no limit to the number of custom geographies NetMinder can support.

Customers love the flexibility custom geographies add to NetMinder. The business information lead for a large national dental insurer tells us: “It is helpful because we are able to focus our reports to match our internal geographical breakouts. We could run the same reports by choosing the 3-digit zip codes that correspond to each area, but having them already grouped for us saves a great deal of time. It also allows us to combine multiple geographical groupings into one report. It is a very beneficial tool for how we do business.”

Some other uses for custom geographies that we’ve found are:

  • Focused recruiting efforts
  • Evaluating network capacity and competitive position to support sales prospecting programs in defined geographies
  • Reporting on network size or makeup in service areas for regulatory and compliance needs

How do you group geographic data when you compare provider networks? What other pieces of data are important to your analysis and how do you match the datasets up?

Tags: network growth, compare networks, network data, network comparisons, Custom Geographies, NetMinder new features

5 Common Problems Encountered When Analyzing Provider Networks and How We Solve Them for Our Customers

Posted by Laura McMullen on Wed, Dec 03, 2014

anlaysis

Comparing provider networks is a standard practice in the employee benefits business. Virtually all networks are available online in searchable directories, so it seems pretty straight-forward on the surface. But, as you know, those directories are designed for consumers to choose providers for themselves and their families near home or work locations, not for network managers to find prospective providers to recruit or for sales people to demonstrate the strengths of their networks vs. the weaknesses of their competitors’. Certainly the process is better and easier than it was with paper directories way back in the Stone Age, but it’s still pretty time-consuming.

Ten years ago, The Ignition Group launched NetMinder to make it easier to compare provider networks accurately and affordably. Over the years, we assembled this list of the top 5 things that make analyzing provider networks difficult and how we solve them for our customers.

  1. Making sure you have all the data from an online provider directory. Some networks return results within a specified radius or a ZIP code while others return a limited number of results. Either way there can be overlap or underlap depending on how you pull the data.
    We systematically mine the data from publicly available websites and compare it to public and private sources to make sure that the file is complete.
  2. Matching providers from one network to another. Ever seen a doctor who’s Robert in three networks and Bob in five others? Or maybe the city name is West Palm Bch in one directory but it is W Palm Beach in three others. All of these variations make matching manually very time-consuming.
    We compare each record to reference tables of name and address variations so that we can match Robert with Bob and West Palm Beach to all of its variations.
  3. Mapping specialties into consistent categories. As providers join networks, their specialty can vary depending on the person signing them up or the way the network groups specialties. So Dr. Smith’s specialty is cardiologist in Network A and cardiovascular medicine in Network B. Where do you put her?
    We map specialties the same way every time so cardiology, cardiovascular medicine, and even interventional cardiology are all part of cardiology – every time.
  4. Ensuring that providers are compared to providers and not to access points or locations and vice versa. Sometimes you get a network list or counts from someone else and they ask you to explain the variation between their report and your network. But they don’t know what’s being counted so you’re not sure where to start.
    We use unique identifiers to relate access points, unique providers, and unique locations so you can run reports for the counting method you choose to always compare apples to apples.
  5. Finding providers who are in some networks and not in others. One way to do this is to pick a network as your benchmark and download all the providers in a given geography. Then you can look each one up in your provider database to see which are in your network. All the providers who aren’t in your network are prospects and you can look for them in each of your competitors’ networks. Eventually you’ll get a picture of each provider’s network affiliations … maybe, if you don’t get interrupted a million times a day.
    We create a single record for each provider that shows all network affiliations and a report to show them to you.

These are just some of the obstacles that NetMinder removes from your daily work. More than 3,500 users run nearly 80,000 NetMinder reports annually to compare provider networks. We do the heavy lifting so that you can concentrate on selling, recruiting, and otherwise growing your business.

How do you compare provider networks?

Tags: provider networks, network comparisons

Changing Supply and Demand for Eye Doctors

Posted by Laura McMullen on Thu, Sep 11, 2014

Recently, the American Optometric Association and the Association of Schools and Colleges of Optometry, along with a number of vision industry leaders, commissioned the Lewin Group to conduct a study of the eye care workforce and create a computer model to continuously study supply and demand for eye care providers. AOA and ASCO leaders called the study “the most ambitious, comprehensive and forward-looking study of eye care supply and demand ever undertaken” in the release announcing the study. To get the National Eye Care Workforce Study go to aoa.org/marketplace (registration and fee required).

The study reports the same three factors that are driving demand for overall healthcare services are affecting the demand for vision care services:

  • The U.S. population is aging and its vision is deteriorating.
  • Diabetes is more prevalent than ever.
  • The ACA expanded the health insurance market and required vision coverage for children.

eye drThe National Eye Care Workforce Study reports an oversupply of optometrists and ophthalmologists through 2025. However, other experts frame a shortage.

One interpretation of the current market shows the supply of eye doctors is growing to meet the increased demand:

  • The supply of eye doctors is increasing. Three new optometry schools graduated their first classes in 2013 and another one will open in Kentucky in 2016. Every year 1,350 new optometrists graduate while 420 retire, according to a presentation Richard Edlow, OD, gave at the Integrated Ophthalmic Managed Eyecare Delivery program in April 2013. Some eye doctors postponed retirement until the U.S. economy rebounded, so the retirement rate will increase as the recovery continues.
  • Eye doctors could see more patients and keep their current schedules. Optometrists surveyed by the Lewin Group as part of the study reported that they could increase patient capacity by 32%, or 933 visits, annually without adding hours or days to their schedules.

Another interpretation shows that supply shortages are on the way while demand is growing:

  • More women are becoming eye doctors. “Fifty percent of ophthalmology residents are female, and 64% of optometry graduates are female,” Dr. Edlow said in his presentation. “Every study indicates that women work about 85% of a full-time employee. If we take this into account, we have 51,000 eye doctors, and we’re going to need 65,000.”
  • Eye doctors are working fewer hours. Most work 40 hours weekly as opposed to 50-60 hours weekly in the past.

The National Eye Care Workforce Study provides a snapshot of the current situation overview and also created a computer model to evaluate the workforce at future points in time. As time goes on and other factors come into play, the supply and demand picture will ebb and flow.

According to NetMinder, the industry standard for vision provider network comparisons, managed vision networks continue to grow, indicating strong demand from consumers and employers for access to vision care.

What do you see in your business?

Tags: NetMinder, vision market, Vision insurance, ACA, consumer choice, network comparisons, vision networks

 

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