Page 31 - Western Wisconsin Health
P. 31
Network (NetFit) Analysis
Lockton’s network discount database provides the most current information available to help clients compare networks from a pricing standpoint. Lockton’s
analysis also factors in cost of care elements like members’ health, medical management, and the impact of ACOs, or narrow networks.
Lockton’s NetFit analysis allows clients to determine whether they should make a change not only based on favorable discount savings but also based on
speciic cost of care elements.
HIGH- DIRECT CENTERS OF REFERENCE- DOMESTIC
ACOS AND PCMH PERFORMANCE PROVIDING TELEHEALTH EXCELLENCE BASED PRICING NETWORKS
NETWORKS CONTRACTING
Providers developing • Carriers creating • Employers contracting Almost universal • 16% of employers • Reference-based • Healthcare providers
accountable care “narrow network” directly with hospitals adoption of telehealth incent the use of pricing (“no steer domestically
organizations (ACOs) products and options and other healthcare services. centers of excellence network plans”) — to their own facilities
and patient-centered — often featuring the providers to lower • 90% of large through value-based reimbursement levels and/or preferred
medical home (PCMH new provider ACOs/ costs and improve employer groups offer beneit design set at percent of partners
models in most major PCMHs quality through telehealth in states Medicare • In some instance,
markets. custom created
• 26% of large employer where allowed by law • Many employers the healthcare client
• 3% of large employer groups are offering networks. • Signiicant upside 3 restricting out-of- may have a custom
groups are directly plans or plan options • Direct collaboration employee utilization network beneits to reimbursement
contracting with ACOs for a high-performance between employers currently at 1%-3% relect a percentage of schedule the carrier
• 21% are promoting network and healthcare • Expanded services Medicare rather than will be asked to
ACO arrangements providers can be such as mental health traditional U&C implement using
available through the effective strategy to and substance abuse service inventories
health plan disrupt the current which include CPT
insurer and healthcare may help to increase and revenue codes,
provider delivery utilization and custom fee schedules
system in favor of self- employer savings including capitation,
funded employers and NPI and Tin
numbers to administer
the network provider
list
Western Wisconsin Health — Lockton Total Rewards Practice overview 31 Lockton Companies
Lockton’s network discount database provides the most current information available to help clients compare networks from a pricing standpoint. Lockton’s
analysis also factors in cost of care elements like members’ health, medical management, and the impact of ACOs, or narrow networks.
Lockton’s NetFit analysis allows clients to determine whether they should make a change not only based on favorable discount savings but also based on
speciic cost of care elements.
HIGH- DIRECT CENTERS OF REFERENCE- DOMESTIC
ACOS AND PCMH PERFORMANCE PROVIDING TELEHEALTH EXCELLENCE BASED PRICING NETWORKS
NETWORKS CONTRACTING
Providers developing • Carriers creating • Employers contracting Almost universal • 16% of employers • Reference-based • Healthcare providers
accountable care “narrow network” directly with hospitals adoption of telehealth incent the use of pricing (“no steer domestically
organizations (ACOs) products and options and other healthcare services. centers of excellence network plans”) — to their own facilities
and patient-centered — often featuring the providers to lower • 90% of large through value-based reimbursement levels and/or preferred
medical home (PCMH new provider ACOs/ costs and improve employer groups offer beneit design set at percent of partners
models in most major PCMHs quality through telehealth in states Medicare • In some instance,
markets. custom created
• 26% of large employer where allowed by law • Many employers the healthcare client
• 3% of large employer groups are offering networks. • Signiicant upside 3 restricting out-of- may have a custom
groups are directly plans or plan options • Direct collaboration employee utilization network beneits to reimbursement
contracting with ACOs for a high-performance between employers currently at 1%-3% relect a percentage of schedule the carrier
• 21% are promoting network and healthcare • Expanded services Medicare rather than will be asked to
ACO arrangements providers can be such as mental health traditional U&C implement using
available through the effective strategy to and substance abuse service inventories
health plan disrupt the current which include CPT
insurer and healthcare may help to increase and revenue codes,
provider delivery utilization and custom fee schedules
system in favor of self- employer savings including capitation,
funded employers and NPI and Tin
numbers to administer
the network provider
list
Western Wisconsin Health — Lockton Total Rewards Practice overview 31 Lockton Companies
