Learn how Andros successfully developed and managed a five-state provider network for a health plan by conducting a market assessment, leveraging technology, and assembling a specialized team, achieving high network adequacy and recruiting thousands of physicians.
They aimed to launch new Medicare Advantage plans in two states where they already had existing products, as well as introduce Medicare Advantage plans in three new states. However, they faced a challenge: their internal network development team was overextended with other projects, and the resources on their commercial team lacked experience with Medicare Advantage requirements.
Andros initiated the project with a comprehensive market assessment to meet the health plan’s cost and quality requirements. Utilizing proprietary technology, we identified and prioritized suitable providers in each county and formed a team to oversee recruiting and contracting. The team used market data to streamline provider negotiations and leveraged expertise and relationships to establish credibility with new providers.
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