Milliman Report: High-Value Healthcare Provider Networks
July 1, 2014

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Overview

Contents


  • Executive Summary 
  • Introduction
  • What is a a "High-Value" Provider Network?
  • How do High-Value Networks Impact Premium Rates?
  • What Reimbursement Structures are Used for High-Value Networks?
  • Criteria for Provider Selection
  • Integration of a High-Value Network into Plan Designs 
  • Care Management Program Considerations Related to Value Networks
  • Market Competition Posturing Using High-Value Networks 
  • Summary
  • Statement of Actuarial Opinion
  • Limitation and Reliance 
 
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High-value networks are developed through a deliberate evaluation process considering quality care protocols as well as fee levels.