Provider Network Optimization

Measuring provider performance has become a major focus for all healthcare organizations trying to address over-utilization, over referrals, and network leakage. Improved transparency between payers and providers is critical to enabling the creation and sustainability of an efficient and effective high-performance network. 

Enable your care and quality teams with actionable intelligence to uncover opportunities around cost savings, utilization management, and provider performance.

The Clinigence Health Provider Network Optimization solutions enable care and quality teams to:

  • Understand, track, and measure key performance indicators
  • Identify and compare the cost of services between provider groups and individual providers
  • Drill down into specific costs and utilization by member/patient
  • Investigate network leakage risks and opportunities by group, PCP, or member/patient
  • Quickly evaluate provider performance against 16 industry standard criteria sets
  • Measure provider groups and providers by efficiency of care analysis