In today’s marketplace, a network must be robust and marketable. Both consumers – and CMS are demanding that plans offer choices that include quality and cost efficiency as well as supplemental benefits. As the new beneficiary ages into a world of patient engagement and incentive and reward programs, they will expect the same level of service.

GHG can help plans and providers evaluate their provider networks, identify the local healthcare market and key stakeholders, and keep open communication in order to meet clinical and financial goals. These strategies will be paramount in putting you ahead of your competition.

Network & Product Strategy

As health organizationsmanage the shift from volume-based patient care to value-based population health management, strategic planning should blend network strategy with product strategy as a key factor in the ability to achieve clinical and financial goals. GHG’s team of veterans can help you implement a network and product roadmap that will lead you to success.

Network Adequacy Assessment

The new regulations surrounding telehealth will likely affect your plans’ adherence to CMS’ network adequacy standards. GHG can help you prepare to meet these new requirements by conducting a network adequacy assessment. We will provide an in-depth analysis of your plan’s status against current CMS requirements, identify areas of concern, and uncover opportunities for growth.

Provider Engagement Architecture

When developing a provider relations and communication strategy, it’s important to also consider the quality, financial, Star Ratings, and risk adjustment goals you need to reach the competitive landscape of healthcare. GHG is poised to assist your plan in developing a provider engagement architecture that ensures the cross-functional needs of your entire organization and its provider network.

Financial Feasibility Study

For more than 20 years, GHG has helped health plans expand their provider networks. We utilize a proprietary tool to build a three-year financial proforma that will satisfy the needs of every department impacted by network expansion. This includes a detailed analysis of the potential markets, the cost of entry, and the risk/reward associated with the new marketplace.

Interim Management

If you are looking for a seasoned veteran, GHG can enrich your network team with our own, providing the leadership and knowledge your organization needs. GHG’s network development experts can supplement your existing team with able professionals who have years of experience providing strategic services to the industry.