Network Design
Network Design is a capability that risk-bearing entities use to identify and partner with high quality providers. Network Design is often an important precursor to value-based contracting because larger groups will have more negotiation leverage and because a high performing network of providers allows for more control over costs and other value-based care outcomes. Companies that provide Network Design services are typically also able to provide Care Navigationservices.
Criteria:
Analytics to evaluate provider quality and/or provider cost
Ability to evaluate and advise on network adequacy, or network completeness against a set of service- and geography-based requirements
Product Usage: The product is primarily used for acquiring commercial payer data to guide negotiations with insurance companies and for marketing to practices.
Strengths: The product’s key strengths include broad data coverage, a responsive team, and highly customizable and well-structured data.
Weaknesses: The product could improve on interpreting and enriching payer data, providing more understanding regarding provider affiliations, and enhancing the main UI to meet specific user needs.
Overall Judgment: The user expresses high satisfaction with the product, finding it to be an excellent choice for their specific data needs.
Product Usage: The product is primarily used for benchmarking; identifying the standard rates negotiated by their competitor set with various payers.
Strengths: The portal feature is viewed as the product’s strength, providing information on payer reimbursement for any service code.
Weaknesses: The product’s weakness is its timing; turnaround times often change and some tasks take longer than expected.
Overall Judgment: Despite the product being in its early stages and less sophisticated, the high level of customer service and reasonable pricing makes Serif an attractive option.