Health benefit plans have a number of really important factors that go into determining how it’s built. Let’s look at how the network fits into that stack. A health plan’s network determines which healthcare providers are included in the plan and at what cost. The network consists of doctors, hospitals, clinics, and other healthcare providers who have agreed to provide services to members of the health plan. Here are some reasons why the network is important:
Health benefit plans often negotiate discounted rates with healthcare providers who are part of the plan’s network. Members who use providers in the network generally pay less for medical services than they would if they went out of network. In some cases, out-of-network care may not be covered at all or may be subject to higher out-of-pocket costs.
Access to Care
By choosing a health benefit plan with a large network of providers, members have access to a wider range of healthcare services and providers. This can be especially important for individuals who have complex medical needs or require specialized care.
Quality of Care
The healthcare providers in a health plan’s network are often vetted for quality of care and patient satisfaction. Members can have confidence in the providers they are seeing and know that they are receiving high-quality care.
Coordination of Care
When members use providers within the network, there is often better coordination of care between providers. Better care coordination can lead to better health outcomes and a more seamless healthcare experience for the member.
Compliance with Plan Requirements
Some health benefit plans require members to use providers within the network in order to receive coverage for certain services. By choosing a plan with a network that meets their needs, members can avoid unexpected costs or denied claims.
The more we know about the factors that go into building a plan, the more we can all work together to find a winning plan. Involving all layers of the plan creation Business owners, HR teams, brokers, and the plan members in the details of plan education creates a more informed team that can make better decisions.
If you would like more insights into other aspects of health plan creation, let us know what we should feature next.