Insurance reform and continued market pressure for a more competitive, higher quality and cost-effective health system are resulting in a transformation of the plan-to-provider relationship, Portico notes, adding that in order to create an affordable care promise, plans are leveraging provider networks.
Portico says plans are investing in provider management capabilities to innovate how they design networks for care, contract for care and pay for the value of care. By implementing these changes, plans are targeting a 25% to 35% decrease in administrative costs, 10% to 20% increase in provider satisfaction, and 1% to 5% improvement in network performance, the company adds.