Employee benefits are becoming more and more complicated. These days, employers often find themselves walking a tightrope between offering benefits that will attract and retain top talent and managing costs—both their own and for their employees.
One solution: network solutions
Network solutions are a unique way to guide members to providers or sites of care that deliver efficient, high quality and cost-effective care. This ensures better health outcomes for members while managing costs for both members and employers.
Here are some examples of network solutions:
Narrow Networks
A narrow network is made up of a specific subset of providers and facilities from the carrier’s broader network. These plans have a lower monthly premium compared to broad plans but come with a limited amount of provider choice. And care is only covered if it’s received from the defined (narrow) provider network.
Narrow networks are a good choice for employers looking to reduce premium costs that are located near a specific network of providers and facilities.
Tiered Networks
A tiered network plan organizes providers into “tiers” based on the value (a measure of cost and quality) of care they provide. They incentivize the use of higher tiered providers without limiting access to the entire network.
Tiered networks are a good choice for employers looking to reduce premium costs, while still giving employees provider or site of care options.
High Performance Networks
A high performance network is a type of narrow network that is made up of a subset of providers and facilities that are selected based on outcomes data. It includes providers and facilities that data analysis has shown consistently deliver high quality and lower costs. Providers in these plans have demonstrated their ability to deliver care more efficiently and cost effectively, potentially driving long-term savings by reducing complications and readmissions.
High performance networks are good for employers who are willing to limit choice for their employees knowing, in the long run, they’ll have better health outcomes.
Centers of Excellence
A center of excellence (COE) is made up of a select network of providers or sites of care based on cost and quality. These providers consistently deliver higher quality care for certain services such as complex procedures or chronic condition management like cancer, musculoskeletal or behavioral health. While not intended for preventive, urgent or emergent care, a COE navigates members to the best performing sites of care and other complementary services.
Employers who add a COE to their plan steer employees to providers with higher outcomes, potentially reducing costs, complications and readmittance rates.