Driving Growth and Differentiation through Network Strategy
A top healthcare insurance company called on Numerof for an independent view on efforts to improve market share and margins. Our rigorous review of network strategy and recommendations supported continued growth through innovative approaches, better alignment, and more productive partnerships with providers.
- Confronted by radical changes to the industry mandated by healthcare reform legislation, this major U.S.-based healthcare insurance company had undertaken a reassessment of its business model, value proposition, and product portfolio.
- New regulations constraining margins, standardizing products, and accelerating commoditization made the status quo untenable.
- To achieve superior margins, the company sought to improve differentiation, build provider network loyalty, and leverage new care delivery approaches.
- Numerof was engaged to assess the company’s network strategy and execution plan with the objectives of identifying new ways to deliver economic and clinical value to their served market and discovering new market opportunities to which their capability set could be applied.
- Leveraging our in-depth experience across the healthcare sector, we reviewed the company’s network strategy from the perspective of key constituent groups, including employers, healthcare delivery organizations, other payers, and consumers.
- Through internal and external interviews and primary market research, we subjected assumptions to a rigorous reality check. We identified opportunities to improve the economic and clinical value delivered and ways to capitalize on unmet market needs consistent with the organization’s strengths and capabilities.
- Numerof supported the client’s redesign of its network strategy with guidance to implement recommendations for (1) building more effective alignment mechanisms with providers; (2) leveraging technology and data assets responsively to deliver outcomes of mutual interest; (3) structuring innovative approaches to care delivery (including bundled pricing, economic and clinical value, management of cost and quality variability, and reduction of non-reimbursable events); and (4) conducting primary market research needed to support plan and care delivery decisions.
- Numerof’s recommendations were accepted and implemented, leading to continued market growth, leadership in consumer directed healthcare, and differentiation based on transparency, outcomes, and consumer choice.
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