Adopting PPACA Network Adequacy Standards
APPLETON, Wis., July 17, 2012 /PRNewswire/ -- With the upholding of the PPACA, every state is now faced with creating or adopting a model to approve Qualified Health Plans (QHPs) that incorporates Network Adequacy standards which validate a health plan's participation in the Health Care Exchange, as well as monitor the networks on an ongoing basis.
Quest Analytics, the leader in Network Adequacy solutions, has developed a proven solution, specifically for measuring and scoring health plans on Network Adequacy requirements. This solution has been utilized to approve health plan participation for federal programs and vetted in every state over the past three years.
Self-Reporting Information is Inadequate
As the stakes get higher for health plans to diversify their participation across various programs, the concerns of self-reporting are heightened. In order to provide a consistent measurement, a solution was deployed that provides states with a fast-track approach to satisfy the Network Adequacy mandate that provides both the necessary transparency and flexibility for an automated adequacy review that assures consistency across all plans and various state programs.
Along with eliminating the concerns of self-reporting, the Network Adequacy model was created with the realization that adequacy standards needed to be more sophisticated and designed around the patterns of care specific to each state to address geographic disparities within each state. As such, the model needed to move beyond basic access standards that applied to every geographic area of a state and instead create a variable standard based on the patterns of care in each state.
"Network Adequacy is fundamental to the qualification of health plans for every Health Care Exchange," shares John Weis, Co-founder of Quest Analytics. John adds, "Leveraging vetted and proven models eliminates adverse selection concerns and provides appropriate consumer protections."
With offices in Appleton, WI and Blue Springs, MO, Quest Analytics has expanded the Network Adequacy Suite to address the requirements of Network Adequacy across all programs within a state. To help state entities meet these requirements, Quest Analytics is providing you with a complimentary white paper to fast-track this effort. To obtain your complimentary whitepaper, visit us at http://www.questanalytics.com/whitepaper.aspx or call 920.739.4552.
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