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Maximize Value Infographics February 02, 2016

Infographic: A Path to Successful Next Generation Narrow Network Offerings

Partner, Health & Life Sciences, Oliver Wyman

We’ve been tracking the world of payer-provider partnerships, which continue to see a significant growth of activity as players look for additional innovations to create higher value and lower-cost offerings for consumers. The importance and value of these partnerships continues to grow. As both the Blue Cross Blue Shield Association and the Robert Wood Johnson Foundation have noted in recent studies, the proliferation of narrower, tighter networks continues to grow, especially in the ACA market. The most innovative versions, as we have observed in prior posts (see sidebar), take a consumer-centic approach in building a coherent network around a clinically integrated provider system or ACO that can help members navigate the system and their care decisions, avoiding unintended consequences such as out of network referrals. These can also lead to unique multi-stakeholder collaborations, such as the Tufts Health Freedom Plan between the Tufts Health Plan and the Granite Health network in New Hampshire. As both payers and providers continue to work to make this space successful, and avoid the risks of poor customer experiences, dissatisfaction, and greater regulatory constraints as a response, our infographic highlights some of the challenges and opportunities:

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