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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

The Fine Line Between Differentiation and Disruption

Posted by Laura McMullen on Thu, Nov 16, 2017

Switching networks can be rough, as the Texas Employees Retirement System found out when they switched to a Blue Cross Blue Shield of Texas HMO plan after using United Healthcare for several years. The Texas Blues plan uses the HealthSelect network which was designed for large groups offering ample coverage in Dallas, Houston, and other big cities. In rural areas, the Blue Advantage network, designed for small groups and individual plans, would have been a better fit, according to local experts. Blue Cross Blue Shield of Texas has moved quickly to address the network gaps. Members who are more than 30 miles from an in-network PCP or more than 75 miles from an in-network specialist can request network gap exceptions. Click here to read the Health Business Daily story that has more details from November 6, 2017. (registration required)

This type of situation happens all the time in the employee benefits industry. A network looks like it matches a group’s locations but when members start making appointments there are gaps. Minimizing network disruption to avoid employee dissatisfaction is often a big factor in making changes to the overall benefits package. Estimating disruption is one of the most common uses of NetMinder.

disruption.jpgCarriers have taken different approaches to managing the inevitable disruption that comes with changing benefit plans and networks.

  • Dental benefits companies frequently “stack” multiple lease partners on top of their direct contract network. Since many lease partners are working with multiple carriers, these networks are very similar which reduces disruption.
  • Vision benefits companies are starting to work with multiple lease partners which reduces disruption when moving between networks as well. Additionally, vision networks rely heavily on retail chains such as Target, Wal-Mart, and JCPenney which also reduces disruption.

Broad medical networks are alike due to the nature of employer-sponsored medical insurance: very few people decline it when offered and virtually all doctors accept insurance because costs are high and utilization is virtually guaranteed over a lifetime. Narrow networks, however, have introduced a new element of disruption into the medical network marketplace. As they continue to evolve, it will be interesting to see what tools and strategies are developed to minimize disruption and dissatisfaction caused by changing plans and doctors while keeping costs down.

How are your networks different from your competition? How do you measure and track the differences?

Tags: medical networks, disruption reporting, network disruption, employee benefits, dental benefits, Vision insurance, healthcare benefits

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

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

 

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