Healthcare provider network and plan design

The provider network and plan design refers to the configuration of healthcare providers and the structure of health plans offered to patients. Effective network and plan designs are crucial for ensuring accessibility, affordability and quality of care for healthcare consumers. The elements directly affect cost management, quality of care and member satisfaction.

Top Stories

Feature 27 Feb 2025
How companies find solutions to employer GLP-1 coverage

Employer GLP-1 coverage has serious cost barriers, but some companies are turning to technology vendors to provide a comprehensive approach to access. Continue Reading
By
- Kelsey Waddill, Managing Editor and Multimedia Manager
- Sara Heath, Executive Editor
Feature 24 Feb 2025
Employers seek healthcare price transparency to control costs

Navigate rising costs by leveraging healthcare price transparency, direct provider contracts and data access, despite ongoing challenges for employers. Continue Reading
By
- Kelsey Waddill, Managing Editor and Multimedia Manager
- Jacqueline LaPointe, Director of Editorial

xtelligent Rev Cycle Management

Private equity exits lead to physician turnover at practices
Private equity exits drive higher physician turnover, impacting retention, care access and market stability, as doctors shift to ...
Trump to expand, enforce healthcare price transparency
A new executive order aims to strengthen healthcare price transparency requirements issued during President Trump's first term ...
How healthcare consumerism is driving provider revenue growth
Learn how providers are aligning more with healthcare consumerism to grow revenue and services and using technology to promote ...

xtelligent Virtual Healthcare

Hospital-at-home lags in rural settings. Is that a problem?
The federal AHCAH waiver has spurred hospital-at-home growth, but adoption is uneven between urban and rural hospitals, raising ...
Non-English speakers face multiple barriers to video visits
Patients primarily speaking Spanish or Cantonese were less likely to participate in video visits due to various technical and ...
What DEA's special registrations mean for telehealth prescribing
The DEA's proposed special registrations for telehealth prescribing of controlled substances could add to provider burdens and ...

xtelligent Patient Engagement

Key features of healthcare case management software
Healthcare case management software needs the ability to integrate with other technologies, including the EHR and patient ...
How docs can meet vaccine hesitancy with empathy
Pediatricians need to be afforded the time necessary to get to know patient needs and concerns to address vaccine hesitancy with ...
Abortion bans affect access in states without restrictions
A new study showed that a Texas abortion ban led to care delays for everyone accessing the procedure in Colorado, a state without...

xtelligent Health IT and EHR

Oracle Health applies for TEFCA QHIN designation
If approved, Oracle Health will be the ninth TEFCA qualified health information network (QHIN), joining Epic, Health Gorilla, ...
Ambient scribing reduces cognitive burden of documentation
While ambient scribing shows promise for clinical documentation efficiency, the technology may be more suitable for certain ...
Early lessons on SDOH data integration across health plans
A new NCQA study found that while SDOH data collection is feasible, health plans face various challenges ranging from siloed data...

Close