Provider Network Development
Having an insufficient provider network can seriously undermine an organization’s chances of having their CMS application approved. Even if approved, a “skinny” network can be a serious competitive disadvantage. Whether on a local or national scale, our team of provider network consultants turn your strategy from vision to reality.
Pre-Application Provider Network Assessments and Development
Our experienced MA provider network consultants will provide a thorough assessment of your existing provider network and or proposed service area to determine whether your planned network is sufficient to meet CMS access standards when you file your application. For plans with existing commercial products and provider contracts, it is critical that in the process of contracting for Medicare, that you do not negotiate a rate for the Medicare contracts "against" your commercial contracted rates, pitting the two sides of your plan at financial odds.
Provider Operational and Revenue Management Assessments
If your plan is operational, GHG can assess how well your network is performing and offer assistance in how to further streamline your provider network operations to maximize the value of your provider contracts, streamline provider network operations, and enhance revenues. We can also provide interim network management services as you shift organizational roles or build out new service areas.
For more information, please contact us at 202-364-8283.
Did You Know…
Having an incomplete provider network is the number one reason why CMS rejects applications for new Medicare Advantage (MA) licenses, but many plans discover this too late, forcing them engage in costly remediation or delay launch for a year.
