APPLETON, Wis., Sept. 10, 2014 /PRNewswire/ — Leaders in delivering Network Adequacy Analysis solutions, Quest Analytics has expanded the Quest Analytics Suite™ to address growing concerns of measuring and monitoring the impact of narrow networks. State and Federal Regulators are faced with challenges of monitoring networks while keeping appropriate consumer protections around access to care, while health plans are faced with providing affordable narrow health care networks. Quest Analytics offers proven solutions for Regulators to monitor networks both broad and narrow alike. "Selecting a network should be similar to buying a car, the fewer features included the lower the price, but regardless of your choice, the gas used should work regardless of the station where purchased," says John P. Weis, Co-founder of Quest Analytics. Quest Analytics takes this concept and applies it to monitoring network adequacy, whereas offering a narrow network can lead to lower premiums; but regardless, access to care should be defined the same for plans competing in the same geographic area.
With heightened concerns over narrow networks, automating a review process was created allowing all networks to be evaluated under the same metrics, providing a win-win approach. "This gives health plans the ability to continue offering narrow networks as a means to control cost and drive efficiencies while providing Regulators with assurances that those networks meet the Network Adequacy requirements, at the same level as any other health plan," adds Weis.
There has been coverage on the negative aspects of health plans shrinking networks in an attempt to control and manage the cost of care. Most health plans have already or will consider developing narrow network options, but doing so without measuring the impact on consumers can be cause for alarm. Creating a narrow network purely based on carve-outs to certain specialties or geographic areas is not acceptable, resulting in consumer backlash and regulatory concerns. In contrast, when network options are designed with analytics, narrow networks provide an attractive alternative and more consumer choices.
The basis of a solid model includes:
- Appropriate specialty types to service needs of membership
- Meet State and Federal Network Adequacy Requirements
- Provide sufficient choice of providers within a given geographic area
- Comparisons against the broad network option vs. the narrow network option
David Hill, Co-founder at Quest Analytics shares, "We've taken the approach of expanding the Quest Analytics Suite™ to provide Regulators with essential tools needed in the market through technology. Using the foundation created with hundreds of health plans, State and Federal Agencies, it's possible to validate narrow networks, while smaller in size, can provide equivalent access to care. Imagine the power of deploying this technology to Regulators giving them balanced solutions to monitor networks to provide consumer protections."
Quest Analytics, is an independent solutions company with a focus on providing automated solutions for network adequacy. Quest Analytics' provides innovative solutions around the challenges facing the healthcare industry, and their industry expertise is sought on a national basis. For more information, visit us at www.QuestAnalytics.com.
Contact: Linda Borths
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920.739.4552