Sustainable Value-Based Care demands managing network alignment and accountability, performance, and efficiency…at the provider AND network level.
Smarter Network Management Means:
Provider accountability that’s based on sustainable influence (rather than utilization) and can be measured and understood through relationships
Consideration of existing preferences and behaviors for members and providers
Connecting members and providers that have strong relationships
Opportunities to Smarten Your Network:
Finding providers who:
- Already work together and have strong relationships with each other
- Best meet the needs of your membership
- Have a strong relationship with your members
Performance defined and measured
Driving better provider support through aligned responsibilities and goals
Strengthening relationships between members and providers
Identify High-Performing Provider Communities
Nascate Performance Metric™
Nascate’s Performance Metric (NPM) is built as a composite of performance measures proven to be associated with better member outcomes, and carefully selected to measure the members’ experience.
NPM scores Nascate Medical Neighborhoods™ (communities of Primary Care Physicians) based on how strong the provider-to-provider relationships are, within that neighborhood.
Higher NPM scores for a neighborhood indicate better neighborhood performance
NPM scores are calculated relative to the neighborhood’s county
NPM is calculated utilizing public and claims data for a more complete picture of referral patterns in a given region
Target actions: Drive members toward high-performing neighborhoods; work with low-performing neighborhoods to improve
Tighten Provider-Provider Relationships
Nascate Care Density
For providers that are seen by a given patient, the tighter the relationships between those providers, the better the outcomes.
Nascate Care Density measures the degree of patient sharing among a set of providers.
The provider score is based on the number of shared patients between providers- the tighter the relationship, the higher the score.
Tighter relationships between the providers that a member sees yields a better experience and better care for that member
Nascate delivers a provider list with a low/medium/high Care Density score indicated for each provider
Target actions: steer members toward high-scoring providers and work with low-scoring providers to educate and support improvement in care density
Tighten Person-Provider Relationships
Nascate Strength of Relationship
When a member’s care is concentrated and consistent over time with one Primary Care Provider, outcomes improve including lower cost and better member experience.
Nascate’s Strength of Relationship score measures the concentration of a person’s relationship with his/her main provider.
The member score is based on the member’s activity with a main provider
Pushing members toward the providers they have a strong relationships with leads to better member experience and improved provider performance
Nascate delivers a member list with a strong/medium/weak Strength of Relationship designation for each member
Target actions: leverage strong relationships for engagement and to influence member behaviors; move members with weak relationships to other providers
Reduce Leakage and Membership Churn
Nascate Early Action Churn
Predict which members are likely to churn and which members are likely to be retained in your network.
Nascate’s Early Action (EA) Churn model quantifies risks associated with churn and assigns the probability of a person’s likelihood to leave the network.
Nascate EA Churn can predict risk of churn for anyone
Reducing churn and retaining the right members increases revenue now and maximizes your existing investment in a member for long-term value
Nascate provides early insight into why a person is at risk for churn, so you can direct outreach and engagement
Target actions: engage members at risk of churning by leveraging existing member-provider relationships