Network Management

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