People may be able to save on premiums by selecting hospitals and doctors in high-performance networks, which are on the rise despite physician complaints, according to an NPR report.
High-performance networks were developed by health plans to encourage enrollees to choose network physicians who score well on measures of efficiency and quality. If these networks influence enough enrollees to shift to high-performing providers, physicians losing market share might be motivated to improve efficiency and quality to better compete, according to a brief by the Center for Studying Health System Change (note: this link is no longer available).
Typically, high-performance networks are an option for different product platforms, most commonly PPOs. The early adopters of the networks have been large national employers and the most common network model consists of tiered-provider levels. The first tier is high-performance providers, while the second is the remaining in-network providers and the third is out-of-network providers.
These plans commonly target physicians, especially specialists, but physicians have reported they felt uninformed about high-performance designations. Physicians particularly feel unsure of how their performance is assessed or how data is compared to other physicians, according to the brief.
Read the NPR report on high-performance networks.
Read more news about health insurance:
-Eliminating Deductible Modestly Improved Screening Rates
-Hospitals, Other Providers Show New Interest in Owning Health Insurance Plans, Despite Falling Profits, Membership
-Widely Used Federal Subsidies for Unemployed May Have Ended for Good
High-performance networks were developed by health plans to encourage enrollees to choose network physicians who score well on measures of efficiency and quality. If these networks influence enough enrollees to shift to high-performing providers, physicians losing market share might be motivated to improve efficiency and quality to better compete, according to a brief by the Center for Studying Health System Change (note: this link is no longer available).
Typically, high-performance networks are an option for different product platforms, most commonly PPOs. The early adopters of the networks have been large national employers and the most common network model consists of tiered-provider levels. The first tier is high-performance providers, while the second is the remaining in-network providers and the third is out-of-network providers.
These plans commonly target physicians, especially specialists, but physicians have reported they felt uninformed about high-performance designations. Physicians particularly feel unsure of how their performance is assessed or how data is compared to other physicians, according to the brief.
Read the NPR report on high-performance networks.
Read more news about health insurance:
-Eliminating Deductible Modestly Improved Screening Rates
-Hospitals, Other Providers Show New Interest in Owning Health Insurance Plans, Despite Falling Profits, Membership
-Widely Used Federal Subsidies for Unemployed May Have Ended for Good