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Six measures of success for Providence Health Plan's network strategy
How good is Providence Health Plan's provider network? At our November producer and employer forums, Regional Director of Network Development Dan Stevens shared our success on six goals for provider network administration.
- Ensure the delivery of the highest quality of care
Contracted Providence Health Plan primary care providers regularly receive feedback via an online scorecard that measures their performance compared to other providers across 12 quality indicators, such as hospitalization rates, mammography rates and effective disease management. Providers can drill down to see and respond to data on individual patients - Employ access and availability standards
Providence Health Plan works to ensure that we have enough providers to meet demand, including many open practices that are currently accepting new patients. - Promote consumer choice and transparency
Providence Health Plan supports comparison shopping by providing members with access to information about the costs of outpatient surgeries, office visits, inpatient services and diagnostic exams. Members also can estimate the annual treatment costs for the most prevalent chronic conditions using our online tools. An online rating system measuring primary care providers' success at preventing and managing disease is built into our online provider directory. - Temper unit price increases
In direct comparison to competitors in Oregon and southwest Washington, Providence Health Plan rated "best in market" in hospital and professional contracting (within the study's margin of error) according to 2008 research conducted by Axene Health Partners. In addition, Providence Health Plan enjoys best-in-market rates with Providence facilities. - Promote quality care through pay for performance
Pay for performance is an important shift away from the pay-for-service reimbursement model that is driving the escalation in health care costs. Today, 50 percent of claims that Providence Health Plan pays for specialty care are paid to a provider who is engaged in at least one of our performance incentive programs. Additionally, 70 percent of primary care physicians in our Portland service area participate in these programs, which support evidence-based health care for our members. - Enable a seamless experience of care
Thanks to 24 percent growth in our network since 2006 and an ambitious statewide expansion in 2008, Providence Health Plan's proprietary network offers coverage at competitive discounts throughout Oregon and southwest Washington. By partnering with First Choice in Washington and Multiplan/PHCS nationally, Providence Health Plan ensures that employees have in-plan access to over 540,000 providers, 4,000 hospitals and 78,000 facilities.
Quality and Costs
Featuring a wide variety of resources to evaluate health services.
