The definitions of both network and product are dramatically evolving in an effort to deliver affordable and quality healthcare.

Network design is undergoing a period of significant innovation as the two traditional archetypes, broad PPO and managed HMO, are being upended by a proliferation of narrow, digital-first, network-within-a-network, COE, and other models. Payers are rapidly learning  that customer and market segment buying dynamics vary significantly, and need to be matched to achieve the 10% cost savings.

Small-p (benefit stack) product is being replaced by Big-P (comprehensive value proposition) product as employer sophistication creates a diverging set of expectations, and customer expectations continue to accelerate in a digital and tech-driven world.

Common issues we help our clients solve

How is my network performing today relative to the competition? Relative to potential?

What are the root-cause drivers (including actuarial spend analysis) of my current network performance barriers?

How can our network strategy help to rationalize and prioritize focus areas and create linkages to other functions (product, provider partnerships, etc.)?

What kinds of alternative networks could I design/implement? How would they compete in the market relative to current performance levels?

How can we optimize network and product design for distinct LOBs? Channels and customer segments?

What are the tech/IT architecture evolution and operating model implications to redesigning my network and product solutions?

What network design, contracting, and negotiations best practices should we employ in our contract/payment model design for network and products?

How can we infuse innovation and differentiation into our product strategy and design processes?