Sub-Category: State Health Plan

More Than Meets the ROI

More Than Meets the ROI

The Situation It was just a single network adequacy gap — a missing endocrinologist in a county in upstate New York — but for Dee Bellanti at the Buffalo-based insurance carrier HealthNow New York Inc., it proved to be the final straw. “For years we had the same lack of network adequacy for that one… Read more »

A Tale of Two Networks

An actual dinner fork sticking out of a road, meant to symbolize two choices

The Situation A managed long-term care program in a large Mid-Atlantic state wanted to expand into new lines of business. To do so, they needed to build two new provider networks: one Medicaid, one Medicare. They started with the Medicaid network, using the tools they had on hand. As the network team describes it, the… Read more »