Provider Network Design
Learn how our custom Smarter Networks℠ drive serious savings for our clients.
Our Provider Networks are Smarter Networks – designed to help employers save money and drive new Benefit Plan Design innovations. By contracting directly with providers on behalf of employers, The Alliance ensures high-quality, convenient, and cost-effective access to care for employees and their families.
Our Smarter Networks℠ can be customized by employers to offer a wide variety of tiered options or to steer their employees to in-network providers that offer high-value care.
In fact, The Alliance Provider Network has continuously evolved over the past 30 years to serve the needs of more than 300 employers throughout the Midwest – each with their own unique goals and challenges. As a not-for-profit coalition of self-funding employers, The Alliance places an emphasis on cost and quality measurement when adding providers to our network, which will continue to evolve to meet the needs of our employers.
In an era where provider networks are getting smaller due to independent providers being bought up by larger systems, The Alliance Provider Networks are continuously expanding to give employees and their families more options for care.
We’re currently serving 30 more counties across the Midwest than we did just five years ago. Our reach has expanded further north and east into Michigan, west into Minnesota, and South into Illinois and Iowa. We are continually monitoring where patients are seeking care and adjusting our network accordingly to help our members avoid expensive out-of-network care.
Comprehensive Care Anywhere
We don’t believe that employers must give up on reducing costs to offer enrollees a broader choice of high-quality, high-value providers. That’s why The Alliance has 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. We created this overlapping network as a comprehensive option for employers who want to offer their employees wide-ranging choice when picking a provider.
Tiered Benefits Plans
We offer sophisticated provider network design using The Alliance Premier Network, which can be customized to include up to four tiers of benefits. The Premier Network offers a preferred option, a secondary preferred option (our Comprehensive Network), and all other out-of-network options. Tiering doesn’t limit where employees can choose to seek treatment, but offers incentives to use lower-cost, higher-value care options.
In other words, our solutions allow employers to drive down the total cost of care by aligning incentives and customizing networks regionally to maximize employers’ investments in their health benefits.
Consistent, Continued Growth
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 adding more employers to our coalition, we can control costs even further and add more value even while we are expanding The Alliance Provider Networks.
Featured Insights on Provider Network Design
Employers are switching to self funded health plans quite rapidly, but the swing from fully insured to self funded health plans did not happen overnight. Health care costs have grown steadily for decades, but they have especially ballooned in recent years. 2022...
We hosted employers for an action-packed hour to talk about how you can guide your employees to avoid costly balance billing. If you missed the webinar, you can view the recording or read on for a detailed recap of this important topic. Out-of-network claims...
Hospital consolidation – when two or more providers merge – has become a growing concern among employers and other health care purchasers, and its presence looms large after facing the fallout of COVID-19. However, hospital consolidation didn’t arrive with the...