Previously we did an article on The Alliance roadmap to high-value health care. It discussed the four core drivers that employers can use to drive high-value health care. This article takes an in-depth look into one of the drivers, provider network design.
The Alliance is recognized in the markets it serves as an employer coalition with deep expertise in self-funding and a focus on data analytics and cost and quality measurement. More importantly, The Alliance delivers a high-performing provider network that employers can use as a platform for benefit plan design and innovation. The Alliance contracts directly with providers on behalf of employers to ensure high-quality, convenient, and cost-effective access to care for employees and their families. Our provider network has evolved and will continue to evolve to meet the needs of employers.
In an era where provider networks are getting smaller, our provider network is continually expanding to give employees and their families more options for care. We are continuously monitoring where patients are seeking care and adjusting our network accordingly to help our members avoid expensive out-of-network care. And, we are growing strategically to add doctors and hospitals in new markets where our members have worksites and where we might serve additional prospective employers. Our growth helps our members’ expanding businesses but also allows us to increase our leverage in the markets we serve by serving more employers.
These initiatives go hand in hand with our efforts to change how we pay providers (another of our core drivers), like utilizing bundled payments for episodes of care. Employers and employees have utilized these services to reduce their overall health care spend.
At The Alliance, we don’t believe that employers must give up on reducing costs to offer enrollees a broader choice of high-quality, high-value providers. Our solutions allow employers to drive down the total cost of care by aligning incentives and customizing networks regionally to maximize employers’ investments in health benefits. That’s how we work to control costs and add value even while we are expanding our network and our offerings.
Kyle Monroe is the Vice President of Network Development & Provider Relations for The Alliance. The Alliance (www.the-alliance.org/NOVO) is an employer-owned, not-for-profit cooperative that moves health care forward by controlling costs, improving quality and engaging individuals in their health. Its more than 250 employer-members provide health benefit coverage to more than 100,000 people throughout the Midwest.
