Making physician quality a cornerstone of your networks “How do I target the right providers for my network?” The answer to this question is increasingly complex. There is an increasing number of variables to consider when evaluating and maintaining provider networks, and one of the most important is physician quality. So how do you leverage this data and take the guesswork out of managing your network? Using Physician Quality to Evaluate Networks Physician quality is perhaps the most important factor in improving patient care and reducing total cost. Including quality data in contracting decisions can transform how networks are evaluated. Zelis offers unprecedented access to physician quality through our analytics tools. Combine the quality data metrics you use internally with physician quality data from Zelis and other third- party sources to enable advanced decision-making for building and maintaining networks tailored for your unique markets and client requirements. Next Generation Network Modeling Zelis Network Modeling combines the industry’s leading network analysis with an advanced platform for leveraging comprehensive provider and network evaluation criteria to support network adequacy, design, and access challenges. Zelis ® Healthcare 866.796.7507 www.zelis.com [email protected] ©2018 Zelis Healthcare. All Rights Reserved. You now have the ability to define custom data inputs to build provider networks based on the needs of your members and your business. Consumer Sentiment Data Cost Data QUALITY DATA Physician Experience Quality of Care Patient Risk Internal Quality- Data Scores NETWORK MODELING OPTIMIZED, FLEXIBLE NETWORK Combine your internal knowledge of provider quality metrics with our best-in-class quality data to manage networks according to your own custom criteria. And all based on the robust Zelis Network Modeling platform for efficiency and scale.
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Making physician quality a cornerstone
of your networks
“How do I target the right providers for my network?” The answer to this question is increasingly complex. There is an increasing number of variables to consider when evaluating and maintaining provider networks, and one of the most important is physician quality. So how do you leverage this data and take the guesswork out of managing your network?
Using Physician Quality to Evaluate NetworksPhysician quality is perhaps the most important factor in improving patient care and reducing total cost. Including quality data in contracting decisions can transform how networks are evaluated. Zelis offers unprecedented access to physician quality through our analytics tools.
Combine the quality data metrics you use internally with physician quality data from Zelis and other third-party sources to enable advanced decision-making for building and maintaining networks tailored for your unique markets and client requirements.
Next Generation Network ModelingZelis Network Modeling combines the industry’s leading network analysis with an advanced platform for leveraging comprehensive provider and network evaluation criteria to support network adequacy, design, and access challenges.
Zelis® Healthcare
[email protected]©2018 Zelis Healthcare. All Rights Reserved.
You now have the ability to define custom data inputs to build provider networks based on the needs of your members and your business.
ConsumerSentiment
Data
CostData
QUALITY DATAPhysician Experience
Quality of CarePatient Risk
Internal Quality-Data Scores
NETWORKMODELING
OPTIMIZED,FLEXIBLENETWORK
Combine your internal knowledge of provider quality metrics with our best-in-class quality data to manage networks according to your own custom criteria.
And all based on the robust Zelis Network Modeling platform for efficiency and scale.
Combine your internal knowledge of provider quality metrics with our best-in-class quality data to manage networks according to your own custom criteria.
And all based on the robust Zelis Network Modeling platform for efficiency and scale.
NETWORK MODELINGTHE NEXT GENERATION OF NETWORK ANALYTICS:
Zelis Network Modeling combines the industry’s leading network analysis tool with an advanced platform for leveraging comprehensive provider and network evaluation criteria to support network adequacy, design, and access challenges.
NETWORK MODELING SCENARIOSThe Network Modeling overview will walk you through several scenarios where the Network Modeling tool will assist in building provider networks based on your internal knowledge of provider quality metrics and our best-in-class quality data.
Optimize a networkFor an existing network, your plan is concerned about the rising expense of several key procedures. Based on your own research, you determined that each procedure has a unique cost driver that you want to focus on to prioritize your recruiting list.
Build a new networkYou’re bidding on a new Medicaid contract in California and you have four months to build out a new network where you have an existing commercial network in place.
Expand into a new service areaYou are expanding your Medicare Advantage service area and need to quickly build out the expanded network.
Build a tiered networkYou are managing the development of a tiered network from your existing PPO in order to steer patients to low cost, high quality providers.
✓ Physician quality
✓ Network accessibility
✓ Network strength
✓ Provider details
✓ Preferred providers
KEY PROVIDER NETWORK ELEMENTS
Zelis® HealthcareNetwork Analytics
Network ModelingScenario Playbook
Sneak Peek
To receive our full Playbook with a step-by-step guide to how you can leverage this next generation network analytics tool, Network Modeling, contact us at [email protected].
[email protected]©2018 Zelis Healthcare. All Rights Reserved.
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