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High-Performance Health Plan Networks: Early Experiences

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Publication Date: May 2007

Publisher(s): Center for Studying Health System Change

Author(s): Debra A. Draper; Allison Liebhaber; Paul B. Ginsburg

Series: Issue Brief No. 111

Topic: Health (Health services administration)

Type: Brief

Abstract:

Health plans have introduced high-performance networks to encourage use of network providers—predominantly physician specialists—deemed high performing on efficiency and quality measures. Early adopters of these networks are large national employers, and, while other employers are interested, actual adoption has lagged, according to a study by the Center for Studying Health System Change (HSC). Enrollment in products using high-performance networks is limited, and objective evidence on the impact on service use, costs and quality is lacking. Early lessons learned indicate the need for effective communication between plans and providers, use of both efficiency and quality measures, industry standards of provider performance, and employer support.