Data and analytics are working their magic, transforming the way we manage provider networks. From evolving technology to regulations, changes are happening all around us. Which begs the question: What strategies are worth incorporating into your 2024 game plan? Keep reading to discover the 5 most popular reports among Quest Enterprise ServicesTM clients last year and 5 provider data and reporting trends for 2024.
The 5 Most Popular Reports by Quest Enterprise Services Clients in 2023
Report #1: Servicing Providers
The Servicing Provider Reports were a standout, providing easy access to comprehensive lists of network servicing providers, prospect servicing providers, and market servicing providers. With multiple filter options, you can customize the data according to your specific needs. One particularly noteworthy aspect is the ability to record and communicate information about each provider’s status, promoting a deeper understanding for others in your organization who work with the data.
Report #2: Network Adequacy Summary by County
In second place, the Network Adequacy Summary by County Reports is essential for addressing compliance concerns. With these reports, you can easily identify compliant and non-compliant counties, track progress, and prioritize network maintenance efforts. These readily available insights keep you informed about the status of your network, ensuring compliance remains a top priority.
Report #3: Aggregate Network Adequacy
Taking the bronze medal are the Aggregate Network Adequacy Reports. Whether you’re interested in a regional, state, or national view of the network, these reports will give you the insights you need. With customizable viewing options and top-down evaluations, you can effortlessly analyze your network to identify strengths, uncover areas for improvement, make data-driven decisions faster, and allocate resources more wisely.
Report #4: Volume Terminations
Securing the fourth position, Volume Termination Reports are beneficial for evaluating provider termination simulations across all networks. By using automation to analyze the potential impact of terminating agreements with specific providers or groups, you can effectively plan for any disruptions in your network. Our clients have commended the efficiency of these reports, as they provide valuable insights for predicting future scenarios and promptly adapting to unforeseen circumstances.
Report #5: Zip Code Summary
Rounding out our top five reports are Zip Code Summary Reports. These reports provide summaries at the zip code level, which are necessary for network adequacy assessments in certain states. By incorporating this extra layer of information, you gain a deeper understanding of the landscape, enabling strategic decisions about resource allocation. Moreover, these reports play a pivotal role in network adequacy exceptions and justifications. With this readily available information, you can efficiently strengthen your network exception requests.
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5 Provider Network Management Trends in 2024
Trend #1: Machine Learning for Provider Selection
ICYMI: Machine Learning has become extremely popular. From helping you find the right provider location to making key decisions about provider suppression, these powerful signals simplify many processes. And because of that, it’s here to stay. So, if you’ve been thinking about incorporating machine learning into your Provider Network Management strategy, 2024 presents the perfect opportunity.
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Trend #2: Integrated Network Adequacy and Provider Data Accuracy Metrics
As compliance requirements increase and oversight tightens, evaluating network adequacy and provider data accuracy separately is becoming more challenging. That’s why in 2024, the approach is to assess them together. By doing so, you simplify the process and create a systematic approach that helps you identify correct data, spot inaccurate information, flag providers requiring further inspection, and address any missing information. All the while understanding how these factors impact network adequacy.
Plus, let’s not forget that regulators love to see your compliance efforts. This approach makes it easier for you to document and defend your process during audits.
Stay review-ready and compliant-confident by following our top 5 best practices for provider data accuracy and network adequacy.
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Want to pass your audit with flying colors? Make sure you’re on the right track from the get-go by capturing the right information! Steve Slaton, VP of Product Management at Quest Analytics shares which provider outreach and verification metrics to track. Plus, learn why summary and detailed metrics are key to compliance.
Trend #3: Simplified Data Consumption
Say it with us: simplification! In a world of overwhelming complexity, we all just want things to be easier, right? Well, trend #3 is all about simplifying data consumption. Visualizations, dashboards, and interactive reports will become more common, streamlining sharing and analyzing information. If your goal for 2024 is to minimize manual reports, hop on this trend.
Trend #4: Automated Network Modeling
Network modeling is going to have an epic glow-up in 2024. This year is about letting technology make it easier for you to test different network simulations. Why is this a hot trend now? As consumer expectations rise and the need for accurate provider directory information increases, it’s crucial to understand the ripple effects of even the smallest network changes. Time is of the essence, and you need information pronto. With automated network modeling, you get quick insights into how adjustments like adding or removing providers impact network adequacy, performance, and coverage. So, here’s the moral of the story: If you want to stay on top and remain a favorite among consumers, don’t sleep on this trend.
Trend #5: Network Optimization for Cost-Effectiveness
Cost-effectiveness – one term that will be on everyone’s minds in 2024. Get ready to see more data and analytics used to optimize networks and reduce costs. By incorporating additional data elements into your network analysis, you can uncover hidden inefficiencies such as ghost providers, and discover high-performing, low-cost providers. Armed with this knowledge, you can negotiate favorable contracts and right-size your network without compromising quality. No more trade-offs, just smart business.
There you have it! The lowdown on the hottest trends in provider network data, analytics, and reporting for 2024. From machine learning and advanced analytics to simplified data consumption and network optimization, it’s clear that the future is bright for provider network management.
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Looking to simplify your workload? Let Quest Analytics take on the heavy lifting! Our solutions and dedicated team specialize in provider data accuracy and provider network adequacy for various lines of businesses, including Medicare Advantage, Medicaid and Commercial. Schedule a strategy session today and see how we can help you every step of the way.