Healthcare today is a world of proliferating value-based arrangements. In addition to accountable care organizations (ACOs) – a flavor of clinically integrated networks (CINs) – “narrow networks” have emerged as a growing trend as the industry shifts to new alternative payment models.
Driven by major U.S. employers seeking lower employee healthcare cost without sacrificing care quality, these new narrow networks offer great promise. This promise is threatened, however, by challenges relating to provider information. Indeed, the absence of an established technology platform that delivers accurate, up-to-date information about the providers within these narrow networks could undermine this nascent value-based approach before it gets off the ground. Whether the problems stem from administrative inefficiencies, payment delays, gaps in network coverage and adequacy, reduced in-network referrals and utilization, or potential loss of market share, new narrow networks must address the provider information challenge to ensure success.
The Rise Of The Narrow Network
Narrow networks go a step beyond HMOs and tiered networks, and limit networks to only providers and hospitals that agree to meet specific quality requirements. Restricting patients to a smaller group of providers and hospitals allows payors to negotiate lower prices with providers and hospitals. They also can incentivize patients to use providers in an accountable care organization (ACO) or similar grouping that’s dedicated to care coordination, improved quality, and controlling costs.....
About Phynd Technologies, Inc.
The Phynd 360° Provider Platform is a strategic enterprise platform managing all operational provider data: who the providers are, where they work, what they do, and what networks they serve. Phynd powers your core processes with robust provider data via easy-to-use provider enrollment, management, reporting and search workflows. Phynd integrates with EHR, credential management, patient-facing websites, and other systems which depend on intelligently searchable provider data. Phynd is used by more than 250 hospitals and is an Epic App Orchard partner. It shares a technology partnership with Healthwise, a leading provider of clinical content. Learn more at www.phynd.com