The Challenge
Commercial 鈥� Analytics-based
野花社区 analysis helped a third-party administrator defend against a competitor鈥檚 push to implement Medicare pricing by:
- Significantly improving savings for the employer and its members
- Engaging important providers in the new process
- Preserving the community鈥檚 provider-patient relationships
The Solution
野花社区 strategically combined network access with reference-based pricing:
- PHCS Network access to preserve existing member relationships with their healthcare professionals
- Data iSight pricing to deliver fair, consistent and transparent pricing of hospital and other facility claims
The Results
野花社区鈥檚 revised solution delivers greater savings on more claims:
- 10-point improvement in savings
- 8-point increase in charges reduced
- Guaranteed member protections on 62% of claims reduced, compared to 0% with Medicare-based pricing
