The Alliance Roadmap to High Value Care Core Driver Three: Provider Network Design

In the past few weeks, we’ve been featuring blogs that break down in greater detail the four core drivers on our roadmap to high-value health care unveiled at our annual meeting this year. Today, we take an in-depth look into the third driver, provider network design, and how it fits into the larger picture of high-value health care.

The Alliance is recognized in the markets it serves as an employer coalition with deep expertise in self-funding and a focus on data analytics and cost and quality measurement. More importantly, The Alliance delivers a high-performing provider network that employers can use as a platform for benefit plan design and innovation.  The Alliance contracts directly with providers on behalf of employers to ensure high-quality, convenient, and cost-effective access to care for employees and their families.  Our provider network has evolved and will continue to evolve to meet the needs of employers.

Pushing Boundaries and Options

In an era where provider networks are getting smaller, our provider network is continually expanding to give employees and their families more options for care. In the past five years alone, we have grown to serve about 30 more counties than we did in 2014, reaching further North and East into Michigan, west into Minnesota and South into Illinois. We are continually monitoring where patients are seeking care and adjusting our network accordingly to help our members avoid expensive out-of-network care.

We have also partnered with Trilogy Health Networks to provide our members with services at hospitals and doctor offices that are not part of our primary network. Plus, we are growing strategically to add doctors and hospitals in new markets where our members have worksites and where we might serve additional prospective employers. Our growth helps our members’ expanding businesses but also allows us to increase our leverage in the markets we serve by serving more employers.

These initiatives go hand in hand with our efforts to change how we pay providers (core driver two, payment reform, featured in our last blog) and our focus on advanced primary care, often delivered through shared-site clinics. Employers have utilized these tools to reduce their overall health care spend while employees are better served by primary care clinicians that can spend more time with them.

In other words, we don’t believe that employers must give up on reducing costs to offer enrollees a broader choice of high-quality, high-value providers. Our solutions allow employers to drive down the total cost of care by aligning incentives and customizing networks regionally to maximize employers’ investments in health benefits. That’s how we work to control costs and add value even while we are expanding our network and our offerings.

What Can Employers Do?

If you are interested in advanced primary care, our provider network expansions, or our four core drivers of health care, please reach out to the Member Service Team. To learn more about how The Alliance works with employers to make health care more affordable, contact our Business Development team.